The case for sterilization

THE CASE
FOR STERILIZATION

THE CASE
FOR STERILIZATION

By LEON F. WHITNEY

FREDERICK A. STOKES COMPANY
NEW YORK MCMXXXIV

COPYRIGHT, 1934, BY LEON F. WHITNEY

All rights reserved. No part of this
work may be reproduced without the
written permission of the publisher.

Printed in the United States of America

CONTENTS

CHAPTER PACK

I. STERILIZATION A BURNING ISSUE TO-DAY . . 7

II. WHAT Is STERILIZATION? 17

III. DOES STERILIZATION WORK SATISFACTORILY? 35

IV. THE EFFECT OF STERILIZATION ON SEX LIFE

AND GENERAL HAPPINESS 57

V. THE RELATION OF MENDELISM TO STERILIZA-
TION 67

VI. IMPORTING TROUBLE 91

VII. DEGENERACY IN THE MAKING .... 105

VIII. A PAGE OF HISTORY 125

IX. How MANY OUGHT To BE STERILIZED? . 143

X. WHAT HAPPENED TO CARRIE BUCK . . . 157

XL CHILDREN NOT WANTED 173

XII. THE OBJECTIONS MOST OFTEN URGED — I 189

XIII. THE OBJECTIONS MOST OFTEN URGED — II 217

XIV. THE WRONG SIDE OF THE LEDGER . . . 233
XV. VOLUNTARY OR COMPULSORY? 249

XVI. PAYING THE PIPER 259

XVII. A PLANNED SOCIETY 273

XVIII. HOLDING THE BEAR BY THE TAIL . . 281

APPENDIX A 295

APPENDIX B 297

APPENDIX C 301

BIBLIOGRAPHY 305

[v]

Choose good grandparents.

—Dr. Oliver Wendell Holmes

Three generations of imbeciles are enough.

— Justice Oliver Wendell Holmes

THE CASE
FOR STERILIZATION

CHAPTER I

STERILIZATION A BURNING ISSUE TO-DAY

CHAPTER I

STERILIZATION A BURNING ISSUE TO-DAY

Since the year 1934 opened there has been a start-
ling increase in the attention given to the subject
of sterilization, an increase which among Ameri-
can newspaper-readers is probably due largely to
the news from Germany that Hitler has undertaken
to have some four hundred thousand Germans
sterilized — nearly a hundredth part of the popula-
tion. Whether this order is or is not directed ex-
clusively at the Jews, it is so grave a decision as to
justify fully the recent discussion of it among thou-
sands of persons in our own country who may
never before have taken any real interest in the
subject.

Many far-sighted men and women in both Eng-
land and America, however, have long been work-
ing earnestly toward something very like what
Hitler has now made compulsory. Ridiculed, even
vilified, they have fought courageously and stead-
ily for the legalization of what they consider a
constructive agency in the betterment of the race.

[7]

THE CASE FOR STERILIZATION

And now they stand watching their fellow-coun-
trymen awaken suddenly to a keen and inquiring
interest in sterilization, and ready to explain what
it is, why it is needed, and how it should be
guarded. The average American, to whom it has
been only a strange or sensational term, now wants
to know just how it may be counted on to work in
the elimination of undesirable elements in society,
along with the burden so long imposed on us by
their multiplication and their helplessness. Steri-
lization has something to do with criminals and
feeble-minded — so much the man-in-the-street
knows ; it has something to do with the question of
birth-control, some connection with inheritable
diseases. Such ideas are to be gathered from the
reading of newspapers and popular magazines.
But beyond these he has little information; and
he is going to need a good deal more if the issue
in our own country is to be considered judiciously
and legislated on with any degree of effectiveness.
Holding no brief for Herr Hitler, approving his
action only because it has served to bring dramati-
cally to public attention a movement that I have
long been interested in, I hope in this book to
clarify the subject of sterilization in all its most
important aspects; to present the case in non-
technical language as far as possible, and to help

[8]

STERILIZATION A BURNING ISSUE TO-DAY

my readers toward a better understanding of the
purposes underlying the sterilization movement.

My own enthusiasm has been developed through
my work, during several years, as Executive Sec-
retary of the American Eugenics Society, an or-
ganization that acts as a clearing-house for all ideas
relating to racial improvement, including steriliza-
tion, and as an active agent in the enactment of
new laws as well as in the enforcement of old. In
the course of considerable study of the problem of
sterilization and related questions in genetics, I
have gathered a good many experiences and ob-
servations that support my whole-hearted enthusi-
asm for the movement, and some of these will
appear in the pages to follow. I include them
because they prove that sterilization is no mere
academic question — it has an immediate and vital
bearing on human life : on our personal happiness,
on the welfare of our families, on the individual
and the community pocket-book, on the quality of
our race in the long run.

Sterilization is at present, of course, a contro-
versial issue. Not every one agrees with Mr. Jus-
tice Holmes that "it is better for all the world if
Society can prevent those who are manifestly unfit
from continuing their kind." How bitter the op-
position is, particularly in some religious quarters,

[9]

THE CASE FOR STERILIZATION

will appear in subsequent chapters. But dissent
comes not only from these quarters; it emanates
too often from persons who have no religious scru-
ples in eugenic matters but who are ill-informed,
or prejudiced, or overhasty in taking their stand
on half-baked notions. And finally there are the
thousands who honestly want to think straight on
this critical question but who have never had the
facts presented to them clearly and fully.

To the pocket-book aspect of our situation to-
day, too, we owe much of the interest expressed in
sterilization. Taxes and charitable funds in huge
amounts annually go to support institutions
crowded with the degenerate, the unfit, the less de-
sirable members of society ; and every citizen feels
the pinch. Not that the whole of our burden of
relief is due to degeneracy; much of it has been
created by the special economic conditions of the
past few years. Competent and useful citizens by
the million have been thrown on charity. But
when these are once more employed and self-sup-
porting, there will still remain a heavy and in-
creasing burden of taxes and charity which can be
reduced for us and for our children after us only
if we take such steps toward racial betterment as
are represented notably by sterilization. Until we
take that step, the feeble-minded person, the habit-

[10]

STERILIZATION A BURNING ISSUE TO-DAY

ual sexual criminal, and the men and women af-
flicted by inheritable disease will all continue to
propagate their kind; women who cannot or ought
not to bear any more children will go on bearing;
our institutions will get more and more crowded
and call on our pocket-books more and more often.
And meanwhile, what of the quality of the race?

The question is tied closely with the matter of
sterilization, more closely than is commonly real-
ized. Many a person who fully appreciates the
desirability of the eugenic movement in general is
likely to shy off at the mention of sterilization, be-
cause the word arouses emotional reactions. If he
is naturally kind-hearted, and has an inadequate
comprehension of the subject, he tends at once to
put himself in the position of the other fellow and
ask himself how he would like being the object of
this form of social discipline. But such a reaction
is often grossly imaginary, conjuring up fears and
objections that are groundless. It is hardly more
than a kind of protective reaction that doubtless
has some connection with individual and race sur-
vival, and it can and often does push us toward
rationalizations and unsound decisions. This fact
is well attested in the personal experience of any-
body who has had much to do with social planning
or social work in general, for it is the human trait

THE CASE FOR STERILIZATION

that is utilized as the basis of appeals for charity.
Any organization seeking help for a group of un-
fortunates knows how effectively it can plead if it
makes you and me feel that we are somehow iden-
tified with those for whom the money is needed.
And so it is with many of us when first we learn
of the sterilization movement; our instantaneous
reaction is, "But suppose I were ever to be the
victim of the sterilization law!" — a reaction which
in itself betrays less than adequate understanding
of the subject, since (as I shall show later) a sub-
stantial number of the very men and women who
need sterilization either submit to it quite will-
ingly or indeed welcome it.

No — our instinctive revolt is negligible, both in
itself and in its relation to the practical problem.
If it develops into active opposition, or — as often
happens — into a tendency to abuse the supporters
of sterilization, it can be successfully met only by
the wider spread of enlightened understanding.
The case for sterilization rests on sound principles,
it has the highest possible humanitarian aims and
the support of countless scientific authorities, and
it is growing more vitally important in our lives
every day. No one can deny that our present trend
is toward a planned society — planned biologically
as well as economically; and no planned social or-

[12]

STERILIZATION A BURNING ISSUE TO-DAY

der is attainable without careful consideration of
the kind of people we want to 'have forming the
race of the future. Inevitably the question arises,
How are we to achieve the desired effect? And
the answer is: Cut off the useless classes by pre-
venting their reproduction, and increase the better
— that is, the useful and self-sustaining, not neces-
sarily the more brilliant. For the sake of our
children, if not for our own sake, we must reduce
the terrific burden of degeneracy that we have
loaded on our shoulders through our policy in the
past. I believe that sterilization is but a part of
the general discipline that we call social planning,
and it is from this point of view that I shall dis-
cuss it.

This is to be no "neutral" book — it is frankly
advocacy of a worthy cause that I have for
many years studied in all its aspects. I have
even debated it on a number of occasions, some-
times taking the side against sterilization. But
after reading all that I could find on the subject
and weighing the evidence carefully, I am now
wholeheartedly in favor of it under certain strictly
defined conditions, and it would be hypocritical to
assume an attitude of neutrality. But by ad-
vocacy I mean educational advocacy of the most
disinterested sort. In two chapters I have brought

THE CASE FOR STERILIZATION

forward all the objections that I have ever heard
urged against sterilization, answering these as hon-
estly as I can and granting that there is weight in
some of them. But the facts and figures presented
throughout the book will prove, I believe, that the
preponderant weight in the end will be found on
the side of those who are urging sterilization. My
position is not that of the scientist of earlier days,
who was supposed only to collect facts and was
not expected to publish the views he had derived
from them except through learned scientific mono-
graphs that could hardly reach the people. In
such a matter as sterilization it is the people who
must be reached ; they can form their own beliefs
and direct legislation wisely only on the basis of the
discoveries and the opinions of the scientist.

CHAPTER II

WHAT IS STERILIZATION?

CHAPTER II

WHAT IS STERILIZATION?

From my own observation I can testify that a
good deal of the opposition to sterilization arises
from ignorance of what it really consists in. Ster-
ilization is not castration. It does not completely
destroy sexual activity, nor does it interfere with
those processes, psychical and emotional, which are
dependent on normal sex functions. It differs
from castration in being partial, its sole effect being
to prevent procreation. The person who is steri-
lized in the ways that I shall describe as satisfactory
continues to enjoy his or her normal sexual activity
but is unable to produce children. I stress this dis-
tinction because it is of the utmost importance and
because I have encountered so many people who
have the wrong idea.

In order to understand the working of the vari-
ous recommended procedures for sterilizing, it
will be useful to review briefly the essential points
in the anatomy and physiology of the sex organs.
To take the female organs first : the most important

[17]

THE CASE FOR STERILIZATION

are the ovaries, ductless glands whose functions are
closely linked with the entire gland system. Each
of the two ovaries contains innumerable micro-
scopic cells which develop into ova. During every
cycle of 28 days there is a period of growth for
some of these cells and of death for others; this
period of growth and death being closely connected
with the female sexual feelings. Many studies
have been made on the sexual cycle in women, one
of the most important being described in a mono-
graph by Dr. George N. Papanicolaou of Cornell
University, which with other work on correlated
facts about reproduction shows that the cycle runs
through the following four stages :

First Period. There is a general
cleansing process ; the lining of the uterus
breaks down, is sloughed off, and is re-
placed by a new lining. Deep within the
ovaries (lying on each side of the uterus)
cells are beginning to grow toward the
surface. During this period there is a
diminution in passion on the part of most
women.

Second Period. This is known as the
copulative period. Ovarian cells which
[18]

WHAT IS STERILIZATION?

will eventually become ova (eggs) are
growing rapidly, each within a sac called
a follicle. This sac contains also a fluid
known as the follicular hormone, which
is absorbed into the blood and for good
reasons is believed to be the chemical
cause of the desire for copulation. The
cells and their surrounding follicles grow
larger, until presently one of the follicles
bursts. When this has occurred, it marks
the virtual end of the copulative period.

Third Period. The post-copulative.
As soon as one follicle has burst, its con-
tents are liberated ; a growth then starts in
the place where that follicle was, and
similar growths start simultaneously in
the follicles that were not ruptured. In
each case the growth not only fills the
follicle but increases to very large pro-
portions— so large indeed that, if we con-
sider the ovary to be about three-quarters
of an inch in diameter, the growth itself
may reach a quarter of an inch in diam-
eter, or more. The growth is called the
corpus luteum or yellow body, and it de-
velops faster than any other body of cells.

[19]

THE CASE FOR STERILIZATION

This process of development is over in a
few days. Furthermore, the corpus lu-
teum secretes a hormone which — working
probably with other hormones — lessens
the desire for copulation, so that for a few
days there is a marked let-down.

Fourth Period. The pre-menstrual,
during which the ovaries are in a more or
less quiescent state. At this time there is
quite generally in women a desire for
copulation, such as is not known in the
lower animals during the corresponding
period.

So much for the 28-day cycle. Now let us see
what happens in the rest of the reproductive tract.
Alongside the ovaries are the fimbrae, bodies that
are something like sponges, attached to the upper
ends of the Fallopian tubes. These are the tubes
connecting ovaries and uterus, their purpose being
to carry the ovum to the uterus, where (if ferti-
lized) it may develop into the embryo. Now, dur-
ing copulation (sexual intercourse) the male's
semen is moved upward in the Fallopian tubes
until it comes to the fimbrae, where it awaits the
appearance of the ova. As we reach this fact we

[20]

WHAT IS STERILIZATION?

are again at the point where we may discuss
sterilization.

How is sterilization of the female to be effected
with the desired good results and with no bad ones?
Obviously, it must not be done through the removal
of the ovaries, since the sexual rhythm and perhaps
even the whole sexual life itself would thereby be
upset, possibly causing still other physiological
disturbances. What, then, is best? The question
is being answered at present in several ways.

Sal ping ectomy. The operation most often per-
formed to-day for sterilizing women is known as
salpingectomy, a simple and safe surgical method
of rendering the Fallopian tubes impassable to the
male sperm in its movement toward the fimbrae.
Once these tubes have been rendered impassable by
means of this operation, which, of course, can only
be performed by a skilled surgeon, fertilization
cannot take place, the unfertilized eggs being ab-
sorbed in the same way in which the other thou-
sands of eggs within the ovaries are absorbed.
When so performed the records of this operation
prove that it is not only simple, but not attended
with any particular danger.

This has now replaced an older and less efficient
operation in which natural growth over a period

[21]

THE CASE FOR STERILIZATION

of time in a number of cases (18%) rendered the
patient again fertile.

Salpingectomy has been performed thousands
of times, without one recorded case of serious com-
plication or of death. Whether salpingectomy
can be undone later — that is, whether by further
surgery fertility may be restored — is still question-
able. So far as I can learn this operation has never
been attempted, though many argue that it is prac-
ticable.

Searing. Still another operation similar in
effect has been devised by Dr. Robert L. Dickinson
of New York. He reasons that it is better, when
practicable, to effect the sterilization without mak-
ing an incision, and he suggests searing within.
This operation also is a simple matter when in the
hands of a skilled surgeon, and leaves the patient
without any permanent bad after effects or any
appreciable amount of surgical shock. The rela-
tive value of searing as opposed to the use of the
knife is a surgical one and the opinions of surgeons
vary upon this point. At any rate both methods are
effective in the sterilization of women. Both of
these operations are better than the use of the X-ray
which will next be mentioned. Searing, too, in the
belief of some authorities, may be undone at a later
date if there is reason for the restoration of the

[22]

WHAT IS STERILIZATION?

fertilizing process ; though like the other this point
is questionable.

The signal advantage of either salpingectomy or
searing is that the operation not only prevents con-
ception but also does not interfere in any way with
the normal sexual activity of the woman. This is
extremely important to bear in mind in connection
with the problem of sterilization.

X-ray. A third method must be described, if
only by way of warning. In private practice the
X-ray has been used, and more often than is war-
ranted by the results. Its use is now decreasing,
and some of the reasons for this may be cited. Al-
though radium and the X-ray have been used with
success in many sterilizations, these two methods
have often produced either failure or at best
unsatisfactory results. One common effect of
treatment by radium or the X-ray is to stop men-
struation— which virtually constitutes castration.
The function of the ovaries is destroyed, and the
hormones are no longer produced.

This is not the worst result, however ; there are
two other considerations of the utmost importance.
The first relates to the effects of radium or the
X-ray when used to bring about temporary steril-
ity. This is sometimes desirable or necessary, and
the treatment is not continued long enough to de-

[23]

THE CASE FOR STERILIZATION

stroy the ovarian function ; normal menstruation is
not interfered with, though conception cannot take
place. When, in time, the effects pass off and the
woman regains her fertility, there is likely to be
trouble ; for among the children conceived shortly
after the treatments, it has been found that a large
proportion were microcephalic idiots — i.e., with
the tops of their heads abnormally small. This
type of child seldom has intelligence and is usually
short-lived. If it survives it becomes the sort of
sad "freak" that one sees in side shows. If the
cause of such monstrosities lies in an unexpected
pregnancy following close on radium or X-ray
treatment, the latter is certainly wrong as a method
of effecting temporary sterilization.

The second consideration is the influence of the
X-ray on the germ-plasm. Experiments on lower
forms of life have shown that mutations (perma-
nent changes) of the germ-plasm can be induced
rather simply by the use of X-rays ; and the changes
observed thus far have always been downward in
the evolutionary scale. A corresponding effect on
the human germ-plasm — permanently altering its
basic cells — would imply a tremendously impor-
tant change in the next generation and all future
generations.

But whatever weight we may or may not give

[24]

WHAT IS STERILIZATION?

to either of these considerations, it is certainly too
early to put much trust in radium or X-ray sterili-
zation ; the method has been in use for too short a
time to produce results that can be checked. The
safest course at present is to say: "When in doubt,
don't."

Male sterilization presents a far simpler prob-
lem, as will be evident on a consideration of the
anatomy and physiology of the male sexual organs.
Here, as in the female, the sex glands (gonads)
constitute the most important part of the mechan-
ism. In the male these glands are the testicles.
They are nourished by a large blood supply and
are made up of millions of tiny tubes called tubules,
each of which is lined with cells. These are the
germ cells, and from them are manufactured the
spermatozoa (or sperm), which correspond to
the ova in the female. Every cell divides several
times, each time working toward the center of the
tube, until eventually, after several divisions, they
change into cells that are able to move about;
under the microscope at this stage they look like
polliwogs. They are now moved along the tubules
until they reach the epididymis, a much larger
tube with many twists and turns which lies just
outside the testicle, and here they are stored.

[25]

THE CASE FOR STERILIZATION

These spermatozoa are extremely minute; we
should have to put hundreds of them together in
order to make a spot large enough to see. The
head of each spermatozoon is its more important
part, its tail (about nine times as long) being for
the purpose of locomotion.

The channel by which the spermatozoa leave the
epididymis is what must interest us in connection
with sterilization. This is the vas deferens, a tiny,
flat, thread-like tube running from the testicle, en-
tering the abdomen through the groin along with
the blood-vessels and the nerves, and passing
around the bladder. There it meets the prostate
gland, and at that point two vesicles or ducts join
with it. It is in these ducts that the semen is stored
— i.e., the fluid that carries the sperm.

When sexual emission occurs, the seminal ducts
discharge the semen, and this causes a suction that
draws millions of the tiny sperm up the vas def-
erens to mix with the semen. Since male fertility
depends on the sperm, it is evident that the best
way to sterilize a man is to prevent the sperm from
reaching the semen; and this can be done by a
rapid and skilled minor operation in the surgeon's
office. This preventive principle was the basis of
Steinach's operation, so much discussed a decade

[26]

WHAT IS STERILIZATION?

ago. Dr. Steinach decided that if the sperm were
not allowed to leave the testicles at all, the energy
thus retained would put new life into an old man ;
this was his "rejuvenation" process. But an im-
portant distinction must be noted between Stein-
ach's operation and the one performed for
sterilization : Steinach, in keeping the sperm from
passing, obstructed the vas in both directions — the
sperm not only could not pass farther along the vas
deferens but also could not issue from the vas at all,
remaining instead in the testicle. This set up a
degenerative process in the testicle that made it in-
capable of producing sperm — a very bad result,
according to Steinach's critics. The vasectomy
used for sterilization, on the contrary, redirects the
sperm so that it can be discharged into the scrotum
(the sac that holds the testicles) ; thus the testicle
continues to produce sperm, which are merely ab-
sorbed into the scrotum.

This matter of the absorption of the sperm is
responsible for some of the objection that exists
to the operation. Many persons have thought that
it must be harmful; they urge that since there is
no special mechanism provided for taking care of
it, the process may lead to disintegration and de-
composition. But the fact is that the human body
is capable of absorbing harmlessly much larger

[27]

THE CASE FOR STERILIZATION

objects than the sperm or the ova. It is not un-
common, for instance, for an embryo to develop
normally during several months and then gradu-
ally become absorbed with no harmful effects.

Vasectomy is the standard operation in use for
sterilizing men, and it is so simple as to require
hardly more than an office call on the physician.
It can be done in a few minutes and there is prac-
tically no risk of complications if proper sanitary
precautions are observed. The operation for ap-
pendicitis, (appendectomy), in an average case
with no complications, is very much more serious
than vasectomy which can, perhaps, be better com-
pared, for importance, with a tonsil operation.
And even here the balance favors vasectomy since
there is no risk of hemorrhage or risk of any kind
beyond that of surgical cleanliness. It is as simple
as that — and no complications have ever been re-
ported as supervening.

Ether is not necessary, but the operation need
not be painful, since the patient can have either gas
or a local anesthetic.

The question has often been raised, by those who
have learned of this operation, whether it can be
corrected — undone — in case this be found advisa-
ble. The point is as yet undetermined : many sur-
geons are confident that it can be done effectually,

WHAT IS STERILIZATION?

while others are doubtful. Such a correcting op-
eration is a far more delicate procedure than the
original vasectomy, though it is not dangerous ; one
side only would have to be reconnected, since the
sperm from one testicle would be more than
enough to insure fertility.

Sterilization through the entire removal of the
testicles, as a therapeutic measure, need not be con-
sidered here, being a medical rather than a eugenic
point.

It can hardly be urged, evidently, that either the
male operation or the female is a very serious mat-
ter. A woman who is sterilized spends two weeks
in bed at the expense of the community; a man
may be put to bed for a week, though actually he
is able to go about his work again almost at once
if the bandaging has been done carefully. In both
cases, as soon as the incisions are healed the thing
is over. Compare these after-effects with those of
another public health measure, vaccination. Here,
and in various serum treatments, there are often
serious and painful after-effects, which among
many people give rise to doubts and even to active
opposition; yet it is obviously the feeling of the
law-making majority that this constitutes a risk
that must be taken for the good of the community

[29]

THE CASE FOR STERILIZATION

— that the benefits accruing from these measures
far outweigh the occasional and exceptional harm
done. And we must add to vaccination and serum
treatments this newer health measure, sterilization,
as at least equal to them in potential benefit to the
race. It differs from them in tending to perma-
nently eliminate misery.

A very important consideration, naturally, is the
effect of either operation on the subsequent sexual
life of the patient. It can hardly be said too em-
phatically that normal sexual activity continues
unimpaired. Desire is not reduced, and the sexual
act can take place just as before ; the only difference
being that now the sterilized person cannot create
a child.

As for that general comfort, happiness, and sense
of well-being that are produced by normal and
unimpeded sexual functioning, the effect of the
operation will be discussed in Chapter IV.

The sterilizing process is already at work natu-
rally, has indeed always been at work, in a way that
nobody wants to see continued. It is mentioned
here only because so few persons realize that it ex-
ists. I refer to the sterility brought about by pros-
titution. The great majority of prostitutes are
sterile because of venereal infection. However
much we may approve of the result (that they can-

[30]

WHAT IS STERILIZATION?

not produce children), we must realize that their
venereal disease is carried to many innocent per-
sons, who may thus be rendered sterile against their
wills. For prostitutes are the chief spreaders of
syphilis and gonorrhea. They are, moreover, pre-
dominantly of low mentality, as shown in Dr. Tage
Kemp's study of Copenhagen prostitutes.1 Half
of the women he examined had the intelligence of
morons or under. Nearly three-quarters suffered
from active venereal disease. Only 35 percent
presented no psychic abnormalities. In our own
country we may read similar findings from Drs.
Yoakum and Yerkes, who in their Army Mental
Tests have this to say about the intelligence of pros-
titutes in the United States :

In several hundred cases investigated
by the psychologists, 53 percent of the
women were ten years mental age or less ;
10 percent were so feeble-minded that
they should have been placed in custodial
institutions. A large percentage of those
who tested above ten mentally showed
marked evidence of mental instability
and in some cases definite mental disease.

1A Study of the Causes of Prostitution, a paper presented
before the International Eugenics Congress, New York, 1932.

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THE CASE FOR STERILIZATION

A relatively small number could be said
to be mentally normal.2

If Nature is working the sterilization of pros-
titutes through their venereal disease, and thus
preventing the propagation of other undesirables,
she is in a sense the ally of those who seek the same
end through artificial sterilization ; but her method
is hardly to be encouraged, if its means is venereal
disease.

2 C. S. Yoakum and R. M. Yerkes, Army Mental Tests,
New York, 1920, p. 196.

132]

CHAPTER III

DOES STERILIZATION WORK SATISFACTORILY?

CHAPTER III

DOES STERILIZATION WORK SATISFACTORILY?

One gratifying feature of the task we have before
us is the wealth of available information already
assembled in the form of records. Many thou-
sands of men and women have been sterilized under
the laws of the United States, and thousands of
others have been sterilized privately. The opera-
tion is gaining favor among many classes of people
and on several different grounds. By this time,
therefore, there are enough data accessible to help
us to determine, provisionally at least, the answers
to two important questions: Has sterilization
proved effective? What do the sterilized subjects
themselves think about it?

During several years before 1929, Mr. E. S.
Gosney and Dr. Paul Popenoe of Pasadena, Cali-
fornia, conducted a study on many aspects of
sterilization, a study based in part on questionnaires
and in part on direct interviews. The results of
this study are found in their Sterilization for

[35]

THE CASE FOR STERILIZATION

Human Betterment* and in a series of eighteen
papers.2 Two of these papers deal with the effect
of sterilization on the patient, one with the attitude
of the patient toward the operation, and another
with the attitude of the patient's relatives. The
complete results constitute one of our richest mines
of concrete facts and figures on the subject, and it
is from the Gosney-Popenoe data that I shall draw
much of the evidence in this book.

The answer, in California, to the first question
above is contained in the fact that of the 2,500
women who were sterilized, only four subsequently
became pregnant, these four having been sterilized
by the old type of operation referred to in Chapter
II ; the proportion revealing the superior effective-
ness of the newer type of operation.

Equally important, however — perhaps even
more important — is the reaction of the patients.
How many of them have been satisfied? Do they
feel remorse over no longer being capable of hav-
ing children? Do they wish that they could have
their reproductive powers restored? The answers
to these questions will appear in our discussion of
the conditions found among the various classes

1 Sterilization for Human Betterment: a Summary of 6000
Operations in Calif orniaf 1909-1929. New York, 1929.

2 For their titles see Appendix A.

[36]

DOES STERILIZATION WORK SATISFACTORILY?

into which the sterilized may be grouped. I be-
lieve that we may take the answers with a con-
siderable degree of assurance that they represent
the real feelings of thousands of subjects, for I
myself have not only examined carefully all the
public records that I could find, as well as such
studies as that by Gosney and Popenoe, but also
have interviewed in person a considerable number
of people who have been sterilized ; and I repeat
that our experience with the operation is suffi-
ciently extensive by now to warrant positive asser-
tion that its results are predominantly beneficial.

The classification offered here needs a pre-
liminary definition of some of its terms if misap-
prehension is to be avoided. By birth-control, for
example, is not meant abortion, or infanticide, or
any of the other things that are often wrongly put
forward as its equivalents; it means merely the
prevention of conception, any method by which the
male sperm is prevented from reaching the female
ovum and thus starting a new life. When, again,
I speak of "therapeutic reasons" for sterilization I
am referring to the cases in which some existing
pathological condition can be cured or arrested or
prevented from getting worse only by sterilization.
Finally, it may be useful to clear up certain general
misconceptions of the meaning of "eugenics." Too

[371

THE CASE FOR STERILIZATION

many people, I find, confuse this with genetics.
Now genetics is the study of the mechanics of
heredity; it will be discussed in the chapter on
Mendelism. Eugenics is quite another matter. It
has nothing to do with sex hygiene, or with anti-
vice movements, or with State-made marriages, or
with the birth of babies to unmarried mothers; it
is not a plan for creating a race of supermen. It
has been called all these things by persons who get
their ideas from news channels of rather less than
perfect authenticity. What eugenics really is has
been perfectly defined by Francis Galton, who
coined the term and who was one of the greatest
scientists of all time :

Eugenics is the study of all the influ-
ences under social control which may im-
prove or impair the inborn qualities of
future generations of man either physi-
cally or mentally.

We live in an age of social control, and here —
in eugenics — lies our most glorious opportunity of
controlling the quality of our children and our
children's children.

The thousands of persons who have submitted to
the sterilization process may be grouped for con-

[38]

DOES STERILIZATION WORK SATISFACTORILY?

venience of discussion into five classes, having been
sterilized

(1) as a means of birth-control;

(2) as a therapeutic measure;

(3) privately, either as a eugenic
measure or for the protection of them-
selves and their families;

(4) punitively, as criminals, and

(5) under the protection of the law,
at the request of parents for social and
eugenic reasons, or as a eugenic measure
by the state.

( i ) As a means of birth-control. No figures are
available for the sterilizations performed as a
means of birth-control, since, when the operation
is resorted to by either husband or wife for this
reason, it is done privately by a surgeon. But my
own inquiries have led me to believe that it is
done thousands of times annually in this country.
One California doctor, for instance, states that he
has sterilized 150 married men for this purpose
during his years of private practice. For certain
reasons I am personally opposed to the adoption of
sterilization for birth-control, believing that in the
great majority of cases the more usual contracep-
tive methods are preferable.

[39]

THE CASE FOR STERILIZATION

Leaving aside for the moment all cases in which
the prevention of conception is desired because the
wife ought never to have any more children — cases
which will be discussed under our second group —
it may be said that the commonest reason given by
married persons in the first group runs something
like this: "We've had enough children and we
don't want any more." Among my own acquaint-
ances I can count half a dozen men, all of a high
type, who have had the operation performed when
they felt that their families were as large as they
wanted or could take care of. One of these has six
fine children. He and his wife are both young,
but they know that their days of wanting babies
are over, and both are perfectly satisfied now that
the husband has been sterilized. Indeed I should
have to go far to find a happier couple. None the
less, I believe that sterilization is not necessarily
called for in such conditions, and still less when the
man and his wife are well on toward middle age
at the time of considering the step. Contraceptive
measures would serve as well. Under our current
social customs marriage is likely to be deferred
until the late twenties, with the result that by the
time a man and his wife have had a number of
children, conveniently spaced, they are both ap-
proaching forty ; which means that the woman has

[40]

DOES STERILIZATION WORK SATISFACTORILY?

only a short time to wait for the menopause, and
during those years the same contraceptive practice
that has served to space out the births will do just
as well to prevent further conceptions. The only
reason for substituting sterilization is apparently
that it saves trouble.

Sterilization is, we must bear in mind, a pretty
final thing in the present state of our knowledge. I
have said earlier that though some authorities be-
lieve that it can be undone, and fertility restored,
others doubt this. I myself have never heard of
such a correction's being even attempted. The
person, therefore, who considers being sterilized to
prevent further children must consider it long and
carefully — must indeed, I should say, be able to
foresee his future and his wife's! For if ever the
time should come when they felt that, after all,
they would like to have another child, they cannot
be sure (so far as we know at present) that the
sterilization can be undone; they may wish that
they had resorted to contraception instead. I have
in mind an example of this. A young man and
his wife, in business together, decided that they
did not want a home and children; so the woman
(against her husband's wishes) went to a hospital
and was sterilized. Five years later the husband
found that he wanted children, and he urged his

THE CASE FOR STERILIZATION

wife to undergo a re-operation to restore her fer-
tility. But she argued that this would mean a risk,
that up to this time their life had been pleasant and
fairly free from risks, and she could not make up
her mind to agree. Then another woman came on
the scene, who was willing to give the man a home
with children. The result was a divorce, the divi-
sion of the business, and — lonely perplexity for
the first wife.

If they had adopted contraception rather than
sterilization, their problem might have been sus-
ceptible of a happier solution.

The procedure is liable to abuse, too, when re-
sorted to for birth-control purposes. I have in
mind the case of a man whose life had always been
filled with adversity. There was no doubt that he
had been used very badly, hounded continually by
ill fortune. When he married (so he has told me)
he and his wife decided not to have children. "I
wouldn't want to bring a child into the world to
risk going through what I have gone through," he
said. "I feel that it is a kindness to the unborn
to keep them unborn." Well, most of us would
probably not agree with him, but I emphasize the
fact that he is, in all respects save this, a fine type
of man and citizen, and I must admit that he and
his wife are utterly happy. Yet here again I be-

[42]

DOES STERILIZATION WORK SATISFACTORILY?

lieve that the sterilization performed on that man
was wrong.

Nor is it only the husband and wife who in my
observation had sometimes put themselves in the
wrong in this matter; the doctors, too, may some-
times exceed their duties. I know of one young
woman who was told by the surgeon after she came
out from an appendectomy, "Now, my dear, there
is one burden that you have off your mind forever.
While I was taking out your appendix I tied off
your tubes, and you'll never have to worry for fear
you'll have babies. Isn't that nice?" Comment is
unnecessary; though exclamation marks are almost
irresistible.

If, however, there are good reasons for steriliza-
tion in order to prevent further births, the opera-
tion should be performed on the less healthy of the
pair in most cases. A physician's advice should be
sought, naturally, since the decision will depend on
the various circumstances surrounding each case.

(2) As a therapeutic measure. The cases in this
group are, strictly speaking, medical rather than
social, but they are included because of the service
that medicine has rendered to society in preventing
the transmission of biological defects. Sexual per-
verts and the emotionally unstable are conspicuous
among the subjects for sterilization with this aim.

[43]

THE CASE FOR STERILIZATION

Such cases will be discussed more fully under (3)
and (5). Here I may mention first the case of the
woman who cannot bear her children normally be-
cause her pelvis is too small and who therefore has
to have a Caesarean operation. It is sometimes
represented that sterilization is here in order be-
cause the woman may transmit this same difficulty
to her girl babies. This I cannot accept, never in
my own observation having known of a Caesarean
girl child who, when grown up, had any harder
time in parturition than if she had been born
naturally; nor is there any evidence to be found
that such a biological defect is transmissible. The
real reason, I believe, for urging sterilization in
this case is the unwillingness of the parents to have
any more children, and I must say that in the cases
I have encountered the woman has seemed to be
perfectly content to be rendered sterile. Many a
woman faced by the choice of having Caesarean
babies or none has found a way out through adopt-
ing children.

Other conditions in which sterilization is indi-
cated for therapeutic reasons are heart disease,
tuberculosis, kidney trouble, and other ailments not
necessarily inherited. Any of these, when coupled
with pregnancy, may bring breakdown or even
death to the mother if the disease is severe, or if

[44]

DOES STERILIZATION WORK SATISFACTORILY?

the pregnancy is not terminated. Plenty of women
with such diseases have had one abortion after an-
other, and — if for no other reason than to relieve
them of worry — these women should be sterilized,
since especially in the case of patients afflicted
with tuberculosis the worry often aggravates the
disease.

(3) Privately, as a eugenic measure or for pro-
tection. Numerous persons have been sterilized by
the family physician or surgeon at their own in-
stance or that of the family. These are usually the
feeble-minded or insane, the kinds of abnormal
persons whose sexual impulses, as is well known,
are likely to be strong and unchecked and who are
therefore a potential menace to society. In these
cases it is useless to ask whether the patients are
satisfied, to seek to learn how they feel about hav-
ing been sterilized ; they are commonly of so low
a mental grade that they are incapable of construc-
tive thinking. But we do know how their parents
and relatives regard the procedure. To them it
means infinite relief from anxiety, the assurance
that the patient will not now bring grief on them
through sexual crimes and perhaps illegitimate
children, and finally the possibility that they can
keep him at home instead of sending him to an
institution.

[45]

THE CASE FOR STERILIZATION

No one knows how many feeble-minded and in-
sane persons are kept in their own homes, or how
many of these have been sterilized. Of the total
number, probably the majority live in country
areas. Indeed, there are many families on run-
down farms all over the land who are one and all
feeble-minded and who go on reproducing their
kind generation after generation, supported by the
community through jobs requiring little or no in-
telligence. Except for its reproductive feature,
such a situation is often not so bad as to call for the
segregation of such persons in an institution. If a
feeble-minded or insane person can be kept at
home, and is sterilized so as to avert the most seri-
ous kinds of trouble, there is no reason why he
should be put away in an institution. He is doubt-
less happier at home, and in certain cases his
family is better satisfied to have him at home.
But certain strict conditions are prerequisite: the
family must be able to take care of him properly,
and must be reconciled to the need of making the
family life revolve around its unfortunate member.
A wealthy family, with a large house and plenty
of servants, which is able to regulate its life to the
chief end of seeing that no harm comes to outsiders
through the presence of the patient, does well to
keep him at home. But any less fortunate family

[46]

DOES STERILIZATION WORK SATISFACTORILY?

conditions — as in a poor rural home — are likely to
lead to trouble in the neighborhood.

What I have just said applies rather to adult
patients than to children, for my observation sug-
gests that the feeble-minded child is often much
better off in a well-run institution among others
of his kind. The staff of such an institution are
trained to handle emotional upsets, which consti-
tute the dangerous element in some cases. More-
over, the family of an adult patient will usually
agree to his sterilization in order to protect them-
selves and others, whereas the permission is hard to
get in the case of a child; which is one more reason
for placing the feeble-minded child (especially if
he is also emotionally deranged) in an institution.

When sterilization is performed on a feeble-
minded child, he usually does not take in what has
occurred and is likely to be as happy afterwards as
before. If there is objection, it is on the parents'
part — they so often simply refuse to give up hope
that their child may "get well some time." But
my impression, in the cases where the operation has
been permitted by the family, has been that they
were eventually very much relieved by it; a ter-
rible responsibility has been lifted from their
shoulders.

In cases where sex perversion can be proved to

[47]

THE CASE FOR STERILIZATION

be inherited, sterilization is permissive in certain
States. That it runs in families there can be no
doubt, but this does not apply to all forms of it.
Not a little sex perversion is developed by our over-
civilization, as well as by early association with the
wrong kind of children. The cure often resorted
to, where perverts become offensive or dangerous,
is castration, this being done not, of course, in the
name of eugenics but rather as a therapeutic meas-
ure, and it is generally effective.

(4) Punitively, as criminals. Sterilization in the
case of criminals should never be regarded as a
form of punishment, but always rather as a eugenic
measure — that is, for racial improvement. Some
of the first laws enacted authorized the perform-
ance of the operation as a punitive measure, and
we may be grateful that in every case our courts
decided against it as "cruel and unusual punish-
ment," and it no longer has any place in our penal
system. There were, in any case, very few sterili-
zations performed on that ground under these
early laws.

Before the passage of any law in Indiana a fairly
large number of sterilizations were performed
with the consent of the criminals themselves — what
is called voluntary sterilization. The operation in
these instances was sanctioned by the State and

[48]

DOES STERILIZATION WORK SATISFACTORILY?

prison authorities, and the usual procedure ran
something as follows :

A criminal would be approached by the prison
doctor or the warden. He would be asked whether
he had any children. If so, how was he able to
support them? Was the State taking care of them?
Did he add another to his family every time he was
liberated? Did his wife like that? Did he like it?
Then how would he like it if a simple operation
were to be performed on him that wouldn't make
the least difference in his sex life, but would make
it impossible for him to have more children?

Every man was skeptical — naturally. "Has any-
body else ever had it done?" "Yes — Mike, down in
the other corridor." Mike would be summoned.
The two would talk it over, Mike proving enthusi-
astic and selling Sam in no time. If you or I had
had ourselves sterilized, we might be ardent advo-
cates of sterilization. So Sam says he'll think it
over, and eventually he decides that it will be a
good thing.

On this basis a great many operations were per-
formed in Indiana institutions, and the men were
eminently pleased. Indeed, the voluntary proce-
dure might still be carried on, had not a law been
passed authorizing sterilization in Indiana. This
law, however, instead of helping along the move-

[49]

THE CASE FOR STERILIZATION

ment, threw so many legal protections about the
patient that the surgeons grew wary and the volun-
tary practice was discontinued. (It has, however,
gone on in other kinds of institutions in Indiana-
charitable, for instance.)

In this group of cases, then, we can say that the
operation has been effective as regards the attitude
of the patients. I myself have talked with men
who have been sterilized and in every case they ex-
pressed complete satisfaction.

A number of States permit sterilization of
habitual criminals. Germany, too, has included
this provision in her sterilization plans. Usually it
is done not as a means of punishment but as a
eugenic or social measure. If a recidivist offender
must spend most of his time in a jail, then it is
hardly fair to society that during every period of
liberty he should cause another child to be born
to his wife, who very likely does not want another,
especially since he cannot support the ones they
already have. A great deal is to be said in defense
of the sterilization of such persons, even when it
is not strictly a eugenic measure.

(5) Under the protection of the law, for social
and eugenic reasons, at the instance of the parents
or the state. In this group we may include all
persons sterilized by the state, whether the initia-

[50]

DOES STERILIZATION WORK SATISFACTORILY?

tive is taken by the patient's family or by public
officials. These are all low-grade persons, nearly
always too stupid or too insane to apply voluntarily
for the operation. Those among the low-grade
class who are so imbecile or so insane that they
will always remain incarcerated do not enter our
present consideration, since in their case there is
no need for sterilization. It is the border-line cases
—those who can be given partial or entire freedom
at times or even permanently — that fall into this
class.

In California it is the custom in nearly all cases
to obtain the written consent of the relatives for
the sake of harmony and the avoidance of litiga-
tion. Institutional superintendents report that
relatives often urge the operation. As most people
know, the type of insanity called manic-depressive
affects its victim periodically; he will get over one
attack and be released, but sooner or later he is
taken with another and must return to an institu-
tion. It is such cases in particular that have bene-
fited by sterilization. Sometimes, during the sane
period, there will seem to be every prospect that
sanity will continue permanently; the husband or
the wife returns home apparently for good, a baby
is born, and then — the victim of the disease falls
once more into depression, to be returned to the

THE CASE FOR STERILIZATION

hospital, the other parent having then to care for
the child or children. Such couples have wel-
comed sterilization, pleading with the physicians
in charge to have the operation performed for the
good of the patient and his or her family. Usually
both husband and wife sign the order for it. When
it is done, everybody concerned looks on it as a
blessing. (See Chapter V for a discussion of the
inheritability of insanity.)

In the case of border-line children, families are
often happy to have the operation performed,
either for the sake of the child or in order to pre-
vent distressing consequences as the child grows
up. More will be said in this book about the
problem of the border-line child, a problem whose
gravity is appreciated by too few persons consider-
ing that this group constitutes the danger-spot of
society.

Any one who has ever had experience in dealing
with feeble-minded persons knows that it is not
hard to persuade them to do something that may
be actually harmful to them. It is for this reason
that they fall victims to foul play so readily, are
so often roped into gangs engaged in deviltry, and
thus come to the attention of the authorities. And
for this same reason it is very easy to persuade them
to undergo the sterilization operation — they will

[52]

DOES STERILIZATION WORK SATISFACTORILY?

assent to almost anything and sign any papers pre-
sented to them. Special care is thus called for if
they are not to be exploited ; they should have all
the protection that a court can throw about them.
And, as a matter of fact, under the sterilization
laws now in use they do have this ample protection.

Such people can be made to tell how much they
think they have benefited by the operation ; while,
in the hands of others, they can, through suggesti-
bility, be made to say they have been badly treated.

Lest any one put himself in the position of a
person to be sterilized and conjure up imaginary
grievances, let me say that such a person knows
very little about the feelings of one needing steri-
lization. The fact is that the greater part of the
operations performed to date have been done with
the consent of the patients, in the case of those with
sufficient mentality to understand what it was all
about; and in most other cases the patients have
been sterilized with the consent of relatives. If
you were insane, I am very sure that you would
never wish to transmit such a condition to any
child of your own. If you loved your children,
surely you would want to spare them the suffering
that you have had to endure. If you were blind,
congenitally deaf, epileptic, or insane, would you
conceivably want to have children badly enough to

[53]

THE CASE FOR STERILIZATION

run the risk of passing on these defects to them?
If you would, you are not like the persons with
these troubles whom I have known.

Let me cite an instance that I myself encountered
not long ago. In this family the mother had Hunt-
ington's chorea — a disease which is inherited, if
one parent has it, by half the children of the mar-
riage. This pair had two children, one of whom
was showing symptoms. I asked them directly
why they had not had other children besides these
two. The mother was plainly shocked that I
should even suggest such a possibility. It was the
deepest sorrow of her life that she had passed her
disease on to the child. And I learned one further
fact, pertinent to our subject: the husband and wife
had for some time been living in virtual celibacy,
for fear of begetting more children, and it was
threatening their health and happiness. She ex-
pressed frankly her strong regret that she had not
been sterilized early in life, as soon as the chorea
appeared, and assured me that if she had known at
the time of her marriage that her disease was in-
heritable and that sterilization was feasible, she
would have had the operation performed then. By
the time I knew her it was a lost hope, for she was
past her menopause; but she was planning to have
her son sterilized, with her husband in agreement.

[54]

CHAPTER IV

THE EFFECT OF STERILIZATION ON SEX LIFE
AND GENERAL HAPPINESS

CHAPTER IV

THE EFFECT OF STERILIZATION ON SEX LIFE
AND GENERAL HAPPINESS

In Chapter III a point was raised that is of the
utmost importance in any discussion of steriliza-
tion: its effects on normal sexual activity and on
the general sense of well-being in the person steri-
lized. If there were any evidence that he or she
complains of a let-down in either the desire for
intercourse or the enjoyment of it, if the operation
has had such systemic effects that the psychic, emo-
tional, and esthetic irradiations of the sex life have
been reduced or lost altogether, then a grave chal-
lenge would be offered. But no such evidence has
appeared. The reports from persons intelligent
enough to testify on the point are with few excep-
tions unanimous in the other direction ; one group,
indeed, finding a new and positive heightening of
these elements.

It is hard for many people to believe this. Some
— particularly those trained in certain historic
religious faiths — find it impossible if not indeed

[57]

THE CASE FOR STERILIZATION

wrong to dissociate the sexual act from the con-
scious intention to produce offspring. Still others,
and there are entirely too many of these, have so
little understanding of the physiology of reproduc-
tion that they jump to the conclusion that
sterilization implies the complete stoppage of
sexual activity. Physicians encounter this attitude
constantly in their practice. When they tell us
that many a pregnant woman thinks that her child
is to be born through the navel, how can we expect
her to know the intricate mechanism and the com-
plex activity of the sexual organs? It is probably
only natural that the majority of people who hear
or read about sterilization should have the idea
that it involves a definite alteration, physical or
psychical, for the worse.

We have seen exactly what is involved physically
in the operation. No organ is removed in either
salpingectomy or vasectomy; in each case a con-
necting tube only is severed. The nervous system
is not meddled with to any appreciable extent.
Knowing this, we should not expect much psycho-
logical change if any. But to make sure, we must
ask the men and women who for one reason or an-
other have been sterilized.

What is perhaps our fullest and clearest source
of statistical information on the subject is two of

[58]

THE EFFECT OF STERILIZATION ON SEX LIFE

the studies made by Gosney and Popenoe in Cali-
fornia.1 The general conclusion to be drawn from
its pages is that, so far as these men could find out,
there was practically no dissatisfaction felt by steri-
lized patients. Both voluntary and compulsory
sterilizations were represented. Of the former
class, the study states emphatically that they were
not only satisfied but even grateful ; of the compul-
sory cases (173 in number) one-seventh were
regretful, the remainder either well pleased or not
dissatisfied. And it may be noted that these com-
pulsory cases were all psychiatric cases, in which
one might naturally expect an augmentation of
mental and emotional disturbance.

For a certain reason it is desirable, in examining
the replies made to the authors of these papers, to
beware of giving equal weight to those from older
persons and to those from younger : the testimony is
largely in the form of questionnaires, which pre-
clude following up the answers with oral questions
that would penetrate further into the underlying
conditions. Thus a sterilized person of middle age
who answers the questions printed might report
that his or her sexual vigor has diminished follow-

1 No. 17 — Effect of Salpingectomy on the Sexual Life; No.
1 8 — Effect of Vasectomy on the Sexual Life. For complete
list see Appendix.

[59]

THE CASE FOR STERILIZATION

ing the operation, when the truth would be that it
was beginning to diminish anyhow, at that age;
the testimony for or against such diminution in
younger persons must be given far more weight be-
cause the effects noted are absolute rather than
relative. Yet, although the California study re-
ports such adverse testimony in the case of a num-
ber of older persons, it is more than offset by the
far greater number (of all ages) who reported an
increase in sexual satisfaction. Of 109 women
studied, for instance, 78 noticed no change, 22
noticed an improvement, and only 9 reported a
decrease. Of 65 men of high type who had been
sterilized privately as a means of preventing pro-
creation, practically all said either that the opera-
tion actually improved their physical satisfaction
and psychical well-being, or else that it seemed to
make no difference. Of 155 women privately steri-
lized, 56 reported improvement, 92 saw no change,
and 7 claimed a decrease.

It is not hard to identify the reason for the pre-
ponderating evidence of satisfactory effects that we
find in this and other studies: the release from
worry, the mental relief consequent on the removal
of fear lest a child may be conceived as the result
of the act. For a considerable number of the per-
sons testifying were men and women whose motive

[60]

THE EFFECT OF STERILIZATION ON SEX LIFE

for sterilization was their reluctance to bring into
the world more children than they could take care
of, or defective children carrying on some trans-
missible trait. What sterilization does for such
persons is to enable them to have intercourse more
frequently and without fear of possible conse-
quences. How markedly the libido (sexual desire)
is heightened when this fear is removed is illus-
trated by the testimony of some husbands that their
wives are always more passionate during pregnancy
— a time when, physiologically speaking, they
might be expected to lose desire.

Though, as has been said, most of those who an-
swered were in favor of the operation, there were a
few who expressed themselves as believing it to be
good for other people but not for themselves. One
of the most interesting recordings is that of the
woman who, after being sterilized, objected vio-
lently; so the physicians considered her case and
wrote to her to return to the institution so they
could operate and restore her fertility. She did
not return.

I should like to describe an experience that came
within my own observation, to show the intimate
connection between fear and the due enjoyment of
intercourse, as well as the occasional real justifica-
tion for sterilizing in the interests of birth-control.

[61]

THE CASE FOR STERILIZATION

In this episode I pitted my own small knowledge
against the much larger fund of a psychiatrist. He
won, but I still think I was right. A man consulted
me about his wife. There was insanity on both
sides of her family, and she had been in an insane
asylum for two years. Now that she was home
again, cured, he wanted to know what to do to keep
her sane and happy. The reason he had come to
me was that a psychiatrist had told him that they
ought to have a second child, "so as to keep her oc-
cupied." She was greatly opposed to the idea, and
so was he. Her fear of pregnancy was growing to
the proportions of a delusion of persecution. So I
suggested, for the sake of her happiness as well as
that of her husband and the nice youngster that
they already had, that either he or she be sterilized,
so that the two could enjoy the normal pleasures of
marriage without the fear of pregnancy on her part
— a fear that might possibly bring on a recurrence
of her insanity.

Well, though the husband was convinced that I
was right, they decided to consult the psychiatrist
once more. After all, he was a professional man,
who ought to know the right thing to do. And it
was his reputation that won. He persuaded them
to have the baby, not the sterilization. The result
of that birth was that the wife was again committed

[62]

THE EFFECT OF STERILIZATION ON SEX LIFE

to the asylum, and from present indications will
stay there for the rest of her life. Thus a home is
broken up, a husband has lost his dearly loved wife,
and their two children are motherless. Now, of
course, it is not possible to dogmatize here, to pre-
dict that the woman would have stayed sane if she
had been sterilized. But what is certain is that
if she had been, or if her husband had been, they
would not have produced a child whose prospect of
mental health and happiness is hardly promising.

And this was only one woman of the millions
whose fear of pregnancy dominates their lives, only
one of the many whom, for one reason or another, it
would be a mercy to sterilize if the conditions are
such that contraception is impracticable. In the
case above, for instance, two such conditions were
present: the woman was too desperately afraid to
put her full trust in any contraceptive measure, and
if the most reliable of these had proved a failure,
and she had conceived, there would have been the
same disastrous outcome as actually did occur.

To attain some degree of control over our own
destinies, to reduce the hold that fear has over our
lives, is a familiar psychological formula for hap-
piness and efficiency. Contraception is proving of
inestimable value in this respect to thousands of
persons, and where contraception does not answer,

THE CASE FOR STERILIZATION

the recommendation should be for sterilization. I
should like to repeat here what I have often said
publicly, that sterilization is the kindest operative
procedure introduced since the discovery of anes-
thesia three-quarters of a century ago. Except for
anesthetics, nothing else has the power of alleviat-
ing or preventing so much human misery.

CHAPTER V

THE RELATION OF MENDELISM TO
STERILIZATION

CHAPTER V

THE RELATION OF MENDELISM TO
STERILIZATION

In any study of sterilization one continually
meets the word "carrier." For instance, in The
Biological Basis of Human Nature 1 Professor H.
S. Jennings speaks of the great hope for racial im-
provement that may come if only a way can be
found by which carriers of racial degeneracy may
be identified. What has this to do with the subject
of sterilization? A great deal. We should know
at least a little about the mechanics of heredity if
we are to discuss the subject intelligently.

For thousands of years it has been recognized
that certain traits seem to skip a generation. These
will appear in one generation, fail to appear in the
next, and then reappear in the third. Plant and
animal breeders were familiar with this fact for
centuries, but it remained for an Augustinian
monk of the little Moravian town of Briinn to
discover the mathematical law governing the

1 The Biological Basis of Human Nature, New York, 1930.

[67]

THE CASE FOR STERILIZATION

phenomenon. At the time — some three-quarters
of a century ago — his valuable contribution to
human knowledge was neither appreciated nor
even widely known; and not until 1900 was it de-
scribed, in a little journal published by the Natural
History Society of Briinn, where it had lain since
1859. This published description constituted the
virtual re-discovery of the Mendelian principles.
With that re-discovery, developments followed
thick and fast in the science which we know to-day
as genetics. Men began to apply Mendel's law to
the inheritance of characteristics in animals and
man. Charles B. Davenport studied human eye-
color, for instance, and found that it is inherited
according to this law. Others studied color in-
heritance in rodents, to such good purpose that by
our own day, if you describe to a geneticist the
color inheritance of a mouse or a guinea-pig, he
can tell you within quite narrow limits, sometimes
exactly, what the color of the offspring will be.
During the same period, Thomas Hunt Mor-
gan and his associates at Columbia University were
studying the mechanism of inheritance in the fruit-
fly. Cytologists (students of the cell) were observ-
ing the components of cells and describing their
discoveries. As for inherited human characteris-
tics, similarly productive work has been done and

[68]

RELATION OF MENDELISM TO STERILIZATION

is still being done. Some of these are found to be
inherited in such complicated ways that the only
method by which they can be studied is the statis-
tical.

If you look at a cell through the microscope you
find within it a little globe called the nucleus,
filled with what looks like granular material. If
you were to observe a long series of these cells, you
would sometimes note curious changes occurring
in them. These mark the process of multiplica-
tion. As is well known, the body grows by an in-
crease in the number of its cells. A cell that is to
grow must divide, forming two cells. When it
divides, all of its component parts divide also.
This should be remembered, since it has a bearing
on heredity.

The granular material in the nucleus congre-
gates into tiny lines called chromosomes. All of
these chromosomes, except sperm cells (sperma-
tozoa) and egg cells (ova), are found in pairs. In
the case of spermatozoa and ova, each has half of
the normal number of chromosomes, which are on
their way to create new individuals and are thus
reduced in order that this new individual may not
receive twice as many chromosomes as its parents
possessed. Every species has a definite number of
chromosomes. We humans have twenty-four

THE CASE FOR STERILIZATION

pairs; fruit-flies have only four pairs. We often
hear biologists say that every individual receives
half his characteristics from one parent and half
from the other. This is because the chromosomes
are the hereditary bridge from one generation to
the next

The chromosomes themselves are made up of
smaller units called genes, and every characteristic
of the body of an animal or a plant is produced
by the interaction of these genes. Like the chromo-
somes, genes go in pairs. It is believed with good
reason that the members of each pair are placed
directly opposite each other in the chromosomes.
In creating the characteristics in the body for
which they are responsible, each two genes work as
a team. When, in the process of reproduction,
they come to be dissociated one from the other we
know that in spite of their intimate relationship,
neither one has influenced the other ; and it is this
stability of the gene that keeps the various inherited
characteristics stable in their turn.

Genes themselves can and do divide, and thus
there is always a lavish amount of germ-plasm, far
more than is ever used. For instance, during
copulation between a male and a female animal,
sometimes as many as 10,000,000 sperm are trans-
ferred. The tassel of the corn plant produces so

[70]

i.

n-r^8

LJ^

^w

Persons aff«ct«<i.

A typical pedigree showing the inheritance of a simple Mendelian
dominant trait (one type of deafness). Many human characteristics
are similarly inherited. Some are good for the individuals possessing
them, some bad, and some neutral in their effects. (Courtesy
Eugenical News.)

RELATION OF MENDELISM TO STERILIZATION

many of the pollen cells, which are as fine as the
finest dust particles, that the air will sometimes be
tinted yellow with it when a breeze lifts them off
the tassel.

Though inherited traits or characteristics are de-
pendent upon the interaction of all the genes, a
difference in one of a pair of genes will make a
very great difference in the end-product — that is,
in the completely developed animal. In your own
case, for example, if one of a pair differs from the
other, this difference may be the direct and specific
source of your ability to throw your thumb out of
joint; or if one of another pair differs, it may mean
that you have the ability to transmit blue eyes to
some of your children although your own eyes are
brown.

What geneticists are trying to do is to learn what
all the inherited traits are. They can hope to do
this with animals, but some people say that they
cannot learn anything about human beings be-
cause they cannot breed human beings as they do
animals. The answer is that they don't have to —
human beings have very obligingly (if uncon-
sciously) done the mating themselves, and have left
records. Often there are three generations of the
same family living, so that the geneticist may go
forth with his measuring instruments and his pen-

[73]

THE CASE FOR STERILIZATION

cil and paper and reach valid conclusions. And,
as research has discovered, for the most part when
a given trait is found to behave in inheritance
according to a certain pattern in one family, it
behaves so in all families. That is because we all
have parts of the same original germ-plasm.

How, then, do we inherit? Well, we must bear
in mind that there is one pair of genes for every
characteristic, and that the child inherits one from
each parent. The father has, let us say, a pair of
genes for blue eyes, and the mother has a pair of
the kind of genes that determine brown eyes. The
child receives one gene from his father's pair and
one from his mother's pair, to reach his full quota
of two. Then, we might ask, what color will his
eyes be? Obviously, in this trait he will be a hy-
brid. But his eyes prove to be brown. Why, you
ask? It is "just because," and that's the best answer
that can be given. Experimental evidence shows
that when a gene for brown eyes is mated with a
gene for blue eyes, the result will be brown eyes.
Mendel said that one character, the dominant,
dominates the other, the recessive. The recessive
(blue-eye character) was there, in the case above,
but you couldn't tell this by looking at the child
because the dominant had been the brown-eye
character.

[74]

RELATION OF MENDELISM TO STERILIZATION

So, in a family which is homogeneous for brown,
nothing but brown eyes can result; and in an all-
blue-eyed family, only blue can be transmitted.
But in a hybrid family, as a geneticist would call it,
there are chances for producing both blue and
brown. Thus two brown-eyed persons — both of
whom, however, have recessive blue-eye genes —
can have a blue-eyed child ; similarly, two persons
who cannot throw their thumbs out of joint will
sometimes produce a child who can. But it is
readily seen that when two recessives marry they
cannot have children bearing the dominant trait.
For the dominant trait is just dominant; if either
parent possessed it, it would be apparent. When
the children of two recessives show the recessive
trait only, it is because no dominant blots it out.

What Mendel did principally was to discover
that there is a mathematical law governing this
matter of inheritance. You can discover it for
yourself if you will take two teacups and put some
white beans in one and some black beans in the
other, both representing genes. Now it is obvious
that from the black cup you can take only black
heredity; from the white, only white heredity. In
each case you have drawn out two "pures." If
you take one from each, you will have a recessive
and a dominant coupled together, and such a com-

[75]

THE CASE FOR STERILIZATION

bination would produce a dominant-appearing in-
dividual. Now make up for yourself some new
generations that will represent the way that selec-
tion works out in Nature. Mix in another cup one
hundred black beans and one hundred white ones;
this is a "marriage" that is to produce some pures
and some hybrids. Take a pencil and paper and
rule three columns. At the top of the first column
make two solid black dots; at the top of the second,
two open white dots; and at the top of the third,
one black dot and one white one. These three col-
umns represent the three possible combinations of
beans which you are going to draw from the cup.
Now you are ready to begin the process of "selec-
tion."

Close your eyes and draw two beans from the
cup at random. They will both be black (pure),
or both be white (pure) , or there will be one black
and one white (hybrid). Whichever pair it is,
make a check in the corresponding column on your
paper. Keep on drawing the beans out, always
with your eyes shut and at random, for that is the
way heredity works. In the end, when all the beans
are out of the cup, you will find that you have
recorded very close to 25 pairs of blacks, 25 pairs
of whites, and 50 pairs of hybrids — one black and
one white. This is the law that Mendel established

[76]

RELATION OF MENDELISM TO STERILIZATION

through growing garden peas. He mated peas
that produced tall vines with peas that produced
short or dwarf vines; and he found that the first-
generation hybrids were all tall, but that when he
mated these hybrids together he got just what you
got when you picked those beans out of the cup.

This is practically all there is to the principle
discovered by Mendel. And when we come to ask
how many human characteristics there are that are
inherited thus simply and that we know to-day, the
answer is about two hundred. If you are interested
in learning what these are, turn to Appendix B,
Table I, where you will find a partial list, domi-
nance and recessiveness being shown.

Now you may say that, if this is all there is to it,
the problem of eradicating degeneracy ought to be
easy : simply find the persons who carry the genes
of mental defectiveness and sterilize them. The
trouble is that there is a good deal more to it than
that. Many of the great, worth-while characteris-
tics of us human beings are not inherited in the
simple manner described above. Certain human
defects are, and these can easily be traced back
through generations. But what about such things
as mental ability? Is that a simple matter? What
about temperament, that very complex trait so im-
portant for human happiness? You see, these

[77]

THE CASE FOR STERILIZATION

things that we find in different degrees cannot be
inherited as simple Mendelian characters are. But
this does not mean that we are helpless in our
efforts to control them.

Who, for example, would say that, if all the
horses in the world were interbred until all types
were merged in a kind of universal mongreliza-
tion, we couldn't quite quickly reestablish the race
horses and the draft horses, and the ponies, and the
polo ponies, and the saddle horses? By selective
breeding we could do it quite easily in fewer years
than we anticipated. Yet racing ability, for in-
stance, is inherited in a very complicated manner,
so complicated that the only way we can study it
is by statistical methods.

Now certain forms of absolute f eeble-mindedness
are inherited as simple recessives. Certain others
— because they are not absolute non-intelligence,
but rather are varying and relative grades of mere
sub-intelligence — are inherited complexly. And
that is why it seems so certain that we can recog-
nize the carriers of f eeble-mindedness ; usually they
are only a little higher mentally than persons who
are actually of lower grades.

The ability to cope with life, to live happily, is
not a simple Mendelian characteristic. Sometimes
one simple Mendelian character will spoil the

[78]

RELATION OF MENDELISM TO STERILIZATION

chances of an otherwise excellent promise of great
capacity. Take Huntington's chorea, for example,
also known as shaking palsy. Without it, some
people would have risen to heights now impossible
of achievement because they were handicapped by
this dominant defect.

There are other characteristics whose mode of
transmission is not very complicated, as for exam-
ple color inheritance in human beings. When a
black woman has a child by a white man, the result
is a mulatto. Mulattoes are of quite uniform color.
When two mulattoes marry and produce children,
the children may range through shades of color
from white to black. There are four colors in the
skin of each of us: white, yellow, red, and black.
If we eliminate the red and the yellow and consider
the white and the black we should find that there
are two pairs of genetic determiners working on the
end-trait color, and this accounts for the varying
degrees of color in children of mulattoes. In other
words, there are a greater number of combinations
possible where four genes are concerned than
where two are concerned.

In considering the many characteristics which
go to make up the individual, we must never forget
that the characteristics that have gone into a com-
bination sometimes come out a generation or two

[79]

THE CASE FOR STERILIZATION

later with new partners. This is another way of
saying that one gene or one chromosome is not
affected by the partner it had while residing in the
body of its temporary custodian. We have all seen
men who are partly white but who have the kinky
hair of the Negro. Occasionally one sees a fairly
black man with light-blue or gray eyes, denoting
that he was probably the son of mulattoes each of
whom had a blue-eyed parent. This is so often the
case to-day that one cannot tell from a man's color
just how much he has inherited from his white an-
cestors, because skin color alone is no criterion.
He may have inherited a majority of the characters
of the white grandparents, even to straight hair,
aquiline features, and so forth, and still have black
skin. In fact, it is my belief that most of the dark
Negroes who are really accomplishing things to-
day are of this type. Unfortunately, many of them
do not themselves know just what their heredity
has been, and this fact has handicapped investiga-
tors, who have had to depend for their studies on
two consecutive generations only.

In accounting for the complicated phases of
heredity, we need but to remember that the more
pairs of genes or determiners involved in the in-
heritance of any trait that interests us, the harder it

=Consf\cuous1^ \a\enUd (genius)

= Musical

d - Deceased. Y= Too x^ou

to

A typical pedigree showing how a worthwhile human characteristic
(musical ability) runs in a family. This is not dominant nor re-
cessive, but a student finds differing grades of it in a pedigree.
Musically inclined persons tend to produce musically inclined children.
They do not always do so, but, on the other hand, often produce
children more musical than they themselves. (Courtesy Eugenical
News.)

RELATION OF MENDELISM TO STERILIZATION

is to study that trait except by statistical methods.
But just as the skin color in the human shows varia-
tion, so — but to an infinitely greater degree — does
the inheritance of some other traits. This explains
why geniuses so seldom produce children who are
geniuses. The parents themselves represent the
upper level of the potentialities of their germ-
plasm, and the subsequent tendency is therefore
downward. But selection continuously maintained
tends to keep the type varying around any given
level.

Knowing these broad principles you will better
appreciate what is meant when we say that some
traits definitely tend to "run in families." Their
inheritance is sometimes too difficult to pin down
to a single pair of determiners, but one family his-
tory after another has shown that certain families
produce these traits generation after generation. A
list of such inherited traits is given in Appendix
B, Table II.

Then there is still another kind of inheritance
called sex-linked inheritance. It was sex linkage
that enabled the early investigators of the genes
to learn what position those lie in along the chro-
mosomes and that thus made chromosome "maps"
possible. When the Nobel Prize was awarded to
Dr. Morgan in 1933 it was largely on the basis of

THE CASE FOR STERILIZATION

this remarkable discovery. By selective breeding
of fruit-flies he and his associates were able to map
out the relative positions which different genes
occupied on the chromosomes. A certain pair of
chromosomes are the determiners of sex. The
male has two sex chromosomes that do not match,
but the female always has a pair that are mates,
and one of the male's is like both of the female's.
That one always comes from the female in inherit-
ance. It is a fifty-fifty chance which one the em-
bryo receives from the father. If it gets the odd
one, the embryo will be a male, while if it gets the
one like that which it received from its mother, it
will be a female.

Along this odd chromosome lie genes for cer-
tain traits from the father ; and along the other one
lie other genes, coming of course from the mother.
The male chromosome sometimes has no genes
complementary to those in the female chromosome,
and when this is so, there is nothing to dominate
the genes from the mother. Traits thus appear
that are sex-linked. Geneticists sometimes say that
these characteristics are recessive in females and
dominant in males, which is partly true. They are
passed on through the mother and do skip a gen-
eration. Thus, the ex-King of Spain has sons who
are "bleeders." They are constantly in danger of

[84]

RELATION OF MENDELISM TO STERILIZATION

their lives because their blood does not have the
ability to clot within the normal time, and they
bleed from any wound for many days. This trait
came from the Queen's father ; King Alfonso had
nothing to do with passing it on. Color-blindness
is another character that one inherits from his
mother's father. Sex-linked traits are seldom pos-
sessed by women because the chances are so small
that any one would receive a pair of determiners or
genes for this one character. If the woman did,
then all her male offspring would possess it,
whereas under ordinary conditions only half would
receive it on an average, because there would be
only one chromosome bearing a gene which was
the determiner for it. A list of some of the sex-
linked traits of man is given in Appendix B, Ta-
ble III.

Some of the traits listed in the Appendix are
exceedingly dangerous, while some are beneficial
or neutral in their effect on the individual. The
essential fact to remember in reading through this
list is that if a person inherits recessives, there is
no chance of his or her transmitting dominants.
And in many cases this holds for the more complex
traits as well. For instance, research fails to dis-
cover a single normal child whose parents were
feeble-minded and were in turn the children of

[85]

THE CASE FOR STERILIZATION

feeble-minded parents. But there are cases on
record in which a feeble-minded person has mar-
ried an insane man and had normal children. That
is because each child received genes for normality
along with the genes for subnormality, and the
normal ones were dominant. But such a child must
indeed watch his step when he comes to marry, for
the recessive genes for subnormality may mate with
other recessives in the sperm, resulting in subnor-
mal children.

In certain cases, two feeble-minded persons have
produced children who would pass for normal;
here, one parent has usually been found to have
come by his or her feeble-mindedness through
other means than heredity. For though the body
may have been affected, the germ-plasm was not,
and the dominant normality overcame the genes
for degeneracy which were furnished by the other
parent.

There are also cases in which a brother and a
sister have produced a child somewhat brighter
than either parent. There is such a child in a Cali-
fornia institution for feeble-minded. It is not
normal, but the inherent potentialities in the germ-
plasm provided for a child slightly higher in the
scale than its parents. I know, too, of a case at the
other extreme, in which a brother and a sister have

[86]

RELATION OF MENDELISM TO STERILIZATION

been married under assumed names for many years
and have two extremely talented children, both of
whom seem fully as intelligent as the parents. The
evidence is good, therefore, that there were no
traits for degeneracy inherent in the parents' germ-
plasm, or they would have stood a much greater
chance of pairing up and thus creating degeneracy.
This is the reason why marriage within a family is
somewhat more dangerous than marriage with out-
siders. If the outsider, however, has the same
traits as the family, then there is no more danger in
marrying within the family than there is in marry-
ing such an outsider. Some of the greatest families
in the world have been the products of quite close
family marriages. The Galton-Darwin-Wedg-
wood family is a case in point. Cleopatra was ex-
ceedingly inbred, if we may apply the same termi-
nology to humans that we use for animals. Many
persons think that cousin marriages are responsible
for a great deal of feeble-mindedness and insanity,
and that our institutions are filled with the results
of such marriages; but this is not so. As I have
said, there is no more danger in cousin marriage
than there is in marriage with an outsider provided
the outsider carries the same genetic traits. In
short, inbreeding does not in itself produce weak-
ness ; what produces it is rather the latent or reces-

[87]

THE CASE FOR STERILIZATION

sive genes for degeneracy, which two members of
the same family are more likely to carry (and so
to combine) than two persons are who are not
members of the same family.

[88]

CHAPTER VI

IMPORTING TROUBLE

CHAPTER VI

IMPORTING TROUBLE

We have no way of knowing just how much
feeble-mindedness and insanity there was in the
United States in the early days, but we do know
that at the very first there was practically none,
because the environment was too harsh to allow a
degenerate to live. Quick wit and ingenuity were
required for survival. That early history consti-
tutes an excellent lesson in what a natural life does
for mankind. There is no place for the misfits in
the upward scheme of evolution. Indeed, if we
can learn anything from that lesson, it is that
Nature certainly does not want weaklings. In
every species, we find that the inferior individual
is soon exterminated and the superior allowed to
survive. So, in the early days of all nations, when
men had to fight for existence, a biologically better
lot of men and women could have been found than
we find to-day, now that civilization has done its
best to save as many weaklings as possible. As we
look back over the history of New England, for

[91]

THE CASE FOR STERILIZATION

example, we find a fairly long period during which
there were no almshouses, town farms, or other
such institutions; and also that after town farms
were established they were occupied for the most
part by a few old people whose dependence was
due less to subnormality than to misfortune.

An intensive study of the history of a typical
New England town, in many aspects related to the
subject of degeneracy, has been made by the writer
and Dr. Arthur Estabrook. We investigated the
earliest census figures, as well as church and town
records, and uncovered some remarkable facts.
The story is so typical of the early development of
rural areas in New England that it will serve well
as an example of the progress of degeneracy in our
country.

The story begins with the petitions made by
dwellers in the eastern part of the State for tracts
of land in the western part, on which they might
settle. The governor made many grants, and set-
tlers emigrated from the neighborhood of Boston
through the woods and sparsely settled communi-
ties between, to the beautiful hill site of the present
town, which we shall call Cellarholes. Here the
soil was terribly poor, and rocks were everywhere ;
but these rugged men and women went to work and
eked out an existence. The village grew rapidly

[92]

IMPORTING TROUBLE

until at one time it had a population of about 1,500.
During the stagecoach and tavern period Cellar-
holes was a prosperous town boasting fifteen or
twenty industries ; and with prosperity there came,
of course, an increased degree of social security.

Now, to understand the whole story, we must go
over to England and see what was happening there.
The news that came from the young colony was
presently so good, bearing promise of such certain
security, that the British Government began to en-
courage emigration and colonization. But did that
government try to select the best of its families and
urge them to emigrate to Massachusetts? No. In-
stead, it allowed those to go who wanted to, and
every once in a while exported a shipload of pros-
titutes and misfits of the same kind as were being
sent to Georgia.

Some of these undesirables drifted to Cellar-
holes, and married; and their children intermar-
ried with the families already there. Moreover,
westward-moving emigrants were continually driv-
ing through the town, and the Cellarholes folk
heard tales of the fertile prairies that these emi-
grants were bound for, and of the fertile Connec-
ticut River valley only a few miles away, and of
the gentle slopes of the Hudson River valley where
there were no stones, and crops had the advantage

[93]

THE CASE FOR STERILIZATION

of longer growing periods. Those who had what
New Englanders still call gumption pricked up
their ears. Those who hadn't were satisfied where
they were.

In time the railroad came through this part of
the State, though eight miles from Cellarholes, and
since almost every foot of the way from railroad
to town was uphill, the townspeople were handi-
capped in getting supplies to Cellarholes. Pres-
ently the young people, particularly those with in-
telligence and ambition, began to seek wider
opportunities elsewhere, in places where life of-
fered more outlet for their energies. So they left
Cellarholes. But what did they leave behind — a
better or a poorer group than themselves? The
answer comes all too readily. As you picture this
selective process going on, generation after gener-
ation, it may occur to you to liken Cellarholes to
a great milk-vat. Running off the top is a tube
that continually siphons off the cream as it rises,
and what is left is skim milk. Much of what is
left in Cellarholes was and is skim milk. The ex-
ceptions are some fine people who have found their
greater opportunities in staying and managing the
town, and a few old people who have come back to
their childhood home to spend their remaining
years. But for the most part, the townspeople can

[94]

IMPORTING TROUBLE

be characterized in a remark made to a circuit
judge who was unfamiliar with the place. He
asked a native who had been called as a witness
what they did in Cellarholes. She replied, "In
summer we raise blueberries, and in winter we
raise hell."

Should you go to the various public institutions
of Massachusetts and look for the names of those
who have come from Cellarholes, you would find
complete quota fulfillment and more. If you were
to go to the county seat and look through the files
of the Humane Society, of the jail, of the charity
organizations, you would find that, considering its
very small present population, Cellarholes has al-
ways had many more persons in constant trouble
than has any other community of corresponding
size.

Degeneracy has increased here, just as it has in-
creased in many another community. Cellarholes
constitutes almost a country slum. Yet it is not
altogether fair to characterize the town thus; for
the countryside is beautiful indeed, and within the
town itself one finds some families of newcomers
who are outstandingly desirable in type — one
Swedish family, for instance, who in true mental
and physical worth probably rank among the top
two percent of our population.

[95]

THE CASE FOR STERILIZATION

If, on the whole, degeneracy has increased in
this New England town to such an extent that a
large proportion of its people now are below par,
it is typical of what may be expected to happen
when good pioneer stock is mixed with bad immi-
grant stock, to combine and recombine so that a
few generations later the mixture is producing
degenerates. I do not imply that most of our de-
generacy can be traced back to England; I want
merely to bring out the fact that innate characteris-
tics producing degeneracy do not for the most part
arise spontaneously.

Let us go a step further. Let us consider the
nation pretty well established so far as security
is concerned. Now, other nations face the prob-
lem of excess population, and America has come
to be generally accepted as the place to send this
excess, in lieu of colonies. Suppose that you were
a public official in, say, Italy. And suppose you
had some inkling of the fact that there are people
and people, that some make good neighbors and
some make troublesome ones. Then suppose, fur-
ther, that you realized that you live on a stony
peninsula, that your land is not adequate to feed
your increasing population. Might it not occur
to you that it would be a fine plan to assist, through
gentle propaganda, some of the surplus to emi-

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IMPORTING TROUBLE

grate? This is what did occur to certain Italian
officials, and they designated a Commissioner of
Emigration who stayed on duty while our Commis-
sioner of Immigration was asleep; at least, our
official seemed powerless to do much to prevent
the coming of those whom the Italian Commis-
sioner wanted to send.

At first, only strong laboring men came over
here from Italy, men who could earn money to
send back to their wives; and they were urged to
return every two years to cement family ties. No
restriction was placed on the migration to America
of the less valuable elements in Italy, and there is
good reason for believing that the best elements
were in various ways urged to stay at home. So
Italy did a little selecting, and on the whole
America would be better off (to put it mildly) if
Italy had not selected in just the way she did.

An error into which some students have fallen
in judging the racial quality of a people is to base
their judgment on the representatives of that peo-
ple here in America. Many contemporary judg-
ments of the Italians offer excellent examples of
this fact. If we were to judge the people of Italy
by the Italians in the city of New Haven, we
should say that there must be six times as much
degeneracy in Italy as among the native-born

[97]

THE CASE FOR STERILIZATION

stock of New Haven. This is far from true, as will
be evident in our further discussion.

Like Italy, the other European nations have
done considerable dumping of their less valuable
population, with the very happy result — for them
— that they have fewer problems of degeneracy
than we have. Why wouldn't they? A few years
ago I arranged a series of illustrated lectures to
be given here by the Norwegian biologist, Dr. Jon
Alfred Mjoen, an honest man and one of the few
Europeans I have ever heard on the subject who
told the facts candidly. He had half a dozen pic-
tures of the most disreputable-looking tramps
imaginable, and while they were being put on the
screen he said not a word. But after they had all
been shown he shocked his audience by saying:
"America has used Norway very badly, through the
more rigid immigration laws which your Congress
has passed. We cannot now send people like this
to America any more ; we shall have to arrange to
take care of them ourselves!"

I could recount one tale after another of assisted
emigration from European countries. Jurists,
knowing full well the expense to their country of
maintaining criminals, have often helped criminals
get to America. Here is how this has been done
repeatedly in England and Germany: A man is

[98]

IMPORTING TROUBLE

tried and convicted by the jury, but the wise judge
says (in effect) to the prisoner, who has been al-
lowed to post a small bail bond, "I shall pass sen-
tence upon you two weeks from Friday, and it will
probably mean that you will go to jail for five
years." Now what has resulted is simply that the
man gathers some money from his friends and
jumps his small bail; then, instead of going to
prison he goes to America, the land of the free.

Though such practices are now happily of the
past, they do explain where many of our traits of
criminality have come from. The fact that Eu-
rope has dumped so much of her expensive and
unwanted human debris on our shores certainly
accounts for most of the seedstock from which our
lower types of degeneracy have sprung.

The subject cannot be left without a further
comment on "country slums." Most city people
seem to think that human beings may not be
thought of as "slum-dwellers" unless they are
herded together. But, as we have seen, a slum is
made by the people who live in it. This ties up
with any estimate we try to make of the source of
degeneracy. We who live in sections of the United
States where the winters are cold are likely to think
that we have more degeneracy than the South has ;
but this is far from being certain. Rather, it is

[99]

THE CASE FOR STERILIZATION

our cold weather that drives more low-grade peo-
ple to ask for help. One outstanding trait of the
low-grade mind is its inability to look ahead.
True, the low-grade city-dweller may sometimes
prosper, for in the city, where everybody is saving
his money and advice is plentiful, a stupid person
may get help from such people as trustworthy bank
employees who will advise him to save his money.
The mere ability to save is therefore no longer any
criterion of mental status. By living on a very
low plane and taking his earnings to the bank, a
low-grade person may accumulate respectable
savings.

But this is not true in country areas. Here the
low-grade person has little chance to earn much,
and in general, because everybody else is trying
hard to work his own land, the yokel works his too
and thus gets enough to eat during the summer. In
most cases he may, it is true, neglect to provide for
the winter ; but when winter comes, if he lives in a
warm climate he needs no fire and in normal times
can get a living. The public authorities do not see
much of him and his youngsters, and so go on
believing that they haven't any serious poverty
problem. On the other hand, foresight is needed
to get through the Northern winter. Then the
country slum-dweller more often comes to the at-

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IMPORTING TROUBLE

tention of the public authorities. With summer
he is able again to go forth and scratch the ground,
sow a few seeds, chop a little wood for the fire, and
impregnate his wife. Everything is fine then, and
nobody has much trouble with him until the next
winter. Our more progressive States are now mak-
ing provision for maintaining more of these un-
fortunates, but at best this is only a beginning,
though many of the officials continually assure the
public that everybody is cared for. In a Connecti-
cut institution for feeble-minded children, for
example, there are 1,000 beds — and unfilled ap-
plications for 1,000 more. Meanwhile the mothers
of these feeble-minded children are still reproduc-
ing; last year they bore no more children. Not
all of these children will live, of course, but enough
of them will to assure the State of Connecticut of
an increasing demand for beds just as long as this
breeding from the bottom continues.

We have now seen enough, undoubtedly, to
summarize. Degeneracy entered this country
originally with undesirables either assisted out of
their own countries or emigrating voluntarily.
These had certain latent, and sometimes apparent,
characteristics that were inheritable. The latent
characteristics cropped out as latent characteristics
will, or else, sometimes, passed in the latent state

[10!]

THE CASE FOR STERILIZATION

from generation to generation to emerge eventually
through the marriage of similar types. A small
amount of our present degeneracy is perhaps to be
accounted for in some other way — by racial inter-
marriage, by environmental differences between
the Old country and the New, or by mutations,
those cases of apparently spontaneous appearance
of some new physical character. But of all such it
may be said either that we know too little about
them as yet to give them much weight, or that they
are relatively small factors, or that they are rare.
We need, in truth, no other explanation for by far
the largest part of our degeneracy than unre-
stricted immigration and the inherited character-
istics of the undesirables who have been admitted
under that policy.

[102]

CHAPTER VII
DEGENERACY IN THE MAKING

CHAPTER VII

DEGENERACY IN THE MAKING

If the latent and the apparent traits of degen-
eracy came to America through immigration and
have been perpetuated here ever since, it seems to
me that we ought to know something of the ge-
netic reasons for the situation. Most of us are
familiar with that great study of human de-
generacy by R. L. Dugdale * which contrasted the
so-called "Jukes" family with the historic Ed-
wards family. Studies have also been made of
other great tribes of degenerates like the Jukes,
most of them living in country slums. Studies of
certain high-grade families like the Edwards and
the Darwins show that such families have pro-
duced practically none but excellent members.
Why should there be such a difference between
family strains?

Before we undertake to ascertain the answer we
must consider one very important question, a ques-
tion to which too little thought has been devoted.

1 The Jukes, New York, 1877.

[I05]

THE CASE FOR STERILIZATION

How many children are required if a family or a
group of families is to be perpetuated? We must
be able to answer this question before we can say
whether a given class of people is increasing or
decreasing.

Several methods have been proposed for de-
termining the point. One of these methods was
followed by Professor Ellsworth Huntington and
the writer in preparing the book called The Build-
ers of America? and I should like to describe it
here. First of all we settled on an arbitrary num-
ber of boys and girls at birth — 100 of each — who
would some day constitute a theoretical inter-
marrying group. Then we said: "Suppose that
all of these children grow to maturity, suppose they
all marry, and suppose they all have children;
how many children would it require to replace
the group in the third generation?" Offhand one
would guess that if they had 200 children, no more
would be necessary. But as a matter of fact, that
assumption would be wrong.

In the first place, abundant figures indicate that
there are 106 boys born for every 100 girls; so it
would be necessary for our 200 to have 206 chil-
dren to perpetuate themselves. But we know that

2 Ellsworth Huntington and Leon F. Whitney, The Builders
of America, New York, 1927.

[106]

DEGENERACY IN THE MAKING

these children will not all live to maturity, will
not all marry, and will not all have children even
if they do marry. So it behooves us to discover
from mortality statistics just what proportion of
them will live to be (say) 24, the age at which a
majority of persons marry. We discovered that
only 85% will live to be that old, which brings our
206 up to 242.

Next we had to find out how many of those who
did live to be 24 actually would marry. Eighty
percent is the figure that records show to be cor-
rect. This means, then, that the 242 has risen to
303, to get 100 married couples in the second gen-
eration.

Lastly, we had to discover what proportion of
those who did marry would have children. In
investigating large groups we found that 85%
would become parents. And that brought our
original 200 up to 356. That is, 356 children would
be required in the second generation in order to
guarantee 100 married couples likely to have chil-
dren. Reducing this to the individual couple, we
determined that it requires 4 children per couple
to perpetuate a family. The average for large
groups, of course, is 3.56 children per couple. So
we see that any group of people that is having
larger families than 3% children is increasing;

THE CASE FOR STERILIZATION

while those who are having smaller families are
decreasing.

In passing, let us investigate the size of the
families of the superior element in the population.
This obviously has a decided bearing on our prob-
lem, for it is the superior elements that support
the inferior as the generations advance, and if more
and more of the inferior come to depend upon
fewer and fewer of the superior — which is what
we mean by a dysgenic birth-rate — plainly the out-
look is grave.

Suppose we consider certain groups of statistics
to find our answer. We know the birth-rates of

(a) many of the great groups of college graduates,

(b) the persons listed in "Who's Who in America,"
and (c) the men listed in American Men of
Science; and, generally speaking, these are supe-
rior men and women.1 Examining "Who's Who"
we find that the average number of children for all
the married men listed is 2.8, while for the mar-
ried women the figure is 2.33. The married scien-

1 "Who's Who" is not to be taken as representing the most
gifted in America. The book itself says, "Not the best, but the
best known." When, however, we make studies of people
we are necessarily limited in our available material to groups
listed in such a form that they may be studied. Neither "Who's
Who" nor American Men of Science represents the cream of
our population; they are taken merely as furnishing a good
cross-section of successful and intelligent Americans.

[108]

DEGENERACY IN THE MAKING

tists listed in American Men of Science average
2.2 children.

Taking all the available figures on college grad-
uates old enough to have completed their reproduc-
tive period, we find that they produce families
averaging 1.75 children; the figure rising to
slightly over 2. if we limit our reckoning to mar-
ried ones. As for graduates of women's colleges,
if we take the entire group (married and unmar-
ried) as a basis of figuring, we find that it has pro-
duced only about 1.25 children per graduate. So
many of the graduates are unmarried that if we
assign the credit where it belongs (i.e., to the mar-
ried ones), the figure becomes almost 2. The
figure for coeducational institutions is somewhat
better than the others, and very much better than
that for the women's colleges.

All told, it is obvious that the average will come
to less than 2.25 children per family for such people
a,s we can scarcely afford to lose from our popula-
tion; for this is a long way from the 3.5 required
to perpetuate a family.

Another fact to consider is the increase in the
total population. It has been reliably estimated
that by 1950 or perhaps earlier the United States
will have a stationary population: the death-rate
and the birth-rate will be equal, so that there will

[109]

THE CASE FOR STERILIZATION

be no further increase such as there has been in the
past. Now 1950 is not far off — indeed it is as good
as here now, from the viewpoint of population in-
crease: the death-rate has almost caught up with
the birth-rate, the relative difference being only
6.9 per thousand.

We now have some important facts at hand.
The country is having practically as many deaths
as births, but our best elements are not producing
nearly enough children to maintain their part in
the population. It becomes necessary now to learn
something about the birth-rate of the people at the
bottom of the social scale and to see whether this
gives us anything to worry over, in its relation to
a planned society and to the problem of steriliza-
tion.

Feeble-mindedness in the race affects all of us,
since we have to spend vast sums in taking care of
the lower grades of our feeble-minded people, with
the realization that the thousands of them who are
free in our population, and are reproducing, will
necessitate our spending more and more. We can
visit the institutions where some of them are segre-
gated, and see for ourselves what they look like;
decide whether they seem good social animals, the
sort that will build up our civilization, or whether
they are the kind to tear it down; ask ourselves

[no]

DEGENERACY IN THE MAKING

whether we should like to have our descendants
marry such as these, or whether for their own good
as well as for ours it would not be better if they
were prevented from having children.

Certain students of feeble-mindedness have tried
to convince the public that only a very small
amount of it is of an hereditary nature. Still
others have admitted that a good deal of it is, but
they insist that there is very little that we can do
about it. Three articles in The Journal of Hered-
ity * have been the basis of much of the discussion
of this question. One of them was by Edward M.
East, the second by R. A. Fisher, and the third by
Leonard Darwin. All were based not on facts
but on an assumption, all argued about a very
large if. Using these three articles as a founda-
tion for further discussion, Professor H. S. Jennings
starts from the same assumption: that feeble-
mindedness is determined by a single pair of genes;
and he then proceeds to speculate on how long it
will take the race to reduce its feeble-mindedness
appreciably.2 His arguments might be convincing
if feeble-mindedness were the result of marriages
between normal persons who produce feeble-
minded children occasionally; but the assumption

1Vols. 8 (1917) and 18 (1927).

2 The Biological Basis of Human Nature, New York, 1930.

[in]

THE CASE FOR STERILIZATION

is not borne out by the facts. So much depends
on our criterion for defining a "normal" person.
Are we to call anybody normal merely because
he has never been committed to an institution?
This is what was evidently done by the persons
whose studies form the basis of the assumption
mentioned. When we look into these studies, this
is what we find to be the criterion used to prove
that feeble-mindedness is not hereditary — i.e., that
it appears as often among children of normal stock
as it does among those of feeble-minded parents :
a research worker is sent to an institution, where
he examines the cards of the inmates, cards de-
scribing the parents among other things. When a
card shows that the inmate is feeble-minded but
that neither his father nor his mother has been an
inmate of such an institution, the parents are re-
corded by the research worker as normal — not
"doubtful" even, but normal. I myself have seen
a study carried out in this way, its evident cri-
terion being merely whether or not the parents
have ever been committed as feeble-minded; if
they haven't, then they are "normal."

Such undiscriminating ambiguity as this, which
reduces the value of the findings considerably, is
attributable to the lack of thoroughness with which
the investigators were obliged to work. They were

DEGENERACY IN THE MAKING

handicapped by being unable to go out into the
towns and give mental tests to these children's
parents, so they had to judge by rule-of-thumb.

In the course of time, however, Dr. H. H. God-
dard issued his sound and valuable study of the
group that he called the Kallikaks. Many of the
parents and the children of this Kallikak group
had actually been inmates of the institution at Vine-
land, N. J., of which Dr. Goddard was the
superintendent; and his findings showed that the
Kallikak feeble-mindedness was to a very large
extent inherited.

In spite of Dr. Goddard's study, however, those
who preferred to believe that it is not inherited
continued to make their own studies on the as-
sumption that unless a person has been an inmate
of an institution for the feeble-minded he is to
be considered normal; the corollary being, of
course, that his admittedly feeble-minded offspring
have been produced from "normal" parentage, and
that the defect is therefore not hereditary. Then
came the publication of the Army mental tests,
showing plainly how overburdened by low-grade
intelligences our country is. Where did all these
feeble-minded persons come from, students began
to ask. Was it indiscriminate immigration that
had introduced so many minus elements into our

THE CASE FOR STERILIZATION

population? Well, undoubtedly this had played
an important part, but the explanation seemed in-
adequate. There must be some other.

Let us look at the proportion of feeble-minded-
ness in our population. There are 60,000 of them
in public institutions in the United States; and
there are at least 300,000 more who ought to be
in such institutions, on the estimate of our foremost
students of the subject. Then there are 3,000,000
other quite low-grade persons who couldn't pos-
sibly get through the grade schools unless they
were led through; i.e., about three such to every
hundred persons in the United States. Now think
through your acquaintances among intelligent peo-
ple; could you find three feeble-minded children
among every hundred normal parents whom you
know? I doubt it. Even if you were to take in
mental grades up to say eleven — the moron grade
— it is doubtful whether you could pick out three
who have come from every hundred of your
friends. It is, then, reasonable to conclude (as did
the Journal of Heredity writers) that feeble-
minded persons spring preponderantly from nor-
mal persons?

A visit to one of these institutions for the feeble-
minded offers many suggestive experiences. On
all such visits that I myself make I ask certain

DEGENERACY IN THE MAKING

questions of the doctors whose duty it is to inter-
view the parents of the inmates, especially the
question whether they consider all these parents to
be "normal." Their common reaction is astonish-
ment, and they have told me that a high percentage
of the parents are decidedly subnormal, though
perhaps not so low in grade as the children. Sev-
eral of the doctors have spoken of the fact that
usually, if one of the parents is of low grade, this
one comes less often than does the higher-grade
parent to visit the child. In other words, the mere
fact that the parents have not actually been insti-
tutional subjects is no indication of the level of
their intelligence.

The story is the same if we visit, instead, our
grade schools for subnormals. Some years ago
the school authorities of several of our American
cities came to think it profitable to classify pupils
according to their intelligence. The theory was
that every pupil must be educated to do something,
though not all of them had equal capacities; a good
many, that is, could not be got through the grades,
yet it was possible that these had a certain sort
of intelligence which might enable them to become
useful citizens. Accordingly, special schools were
provided for these subnormals. Pupils who, in
the classes for normal children, appear to be ex-

[us]

THE CASE FOR STERILIZATION

tremely backward, are examined by trained psy-
chologists and, if found to be subnormal, are given
a manual education in the special schools.

In New Haven from 1819 to 1929 five thousand
pupils were educated in these special schools, and
the number would be even larger if the buildings
had been adequate during the early years of the
movement. This means that out of a total popula-
tion of 160,000, there have been 5,000 between the
ages of eight and fourteen who were subnormal, a
large proportion being of foreign-born and Negro
parentage.

I have visited these schools, putting again the
question I put to the authorities in the institutions
for feeble-minded: "How many normal parents
do you have coming to this school to visit their
feeble-minded children?" And the usual reply is,
"Very few indeed." This testimony here is that
subnormal children come from subnormal parent-
age, not from normal. To the authorities this
seems so safe a generalization that it is possible
to predict with reasonable certainty, when one
child comes to the school and the records indicate
that there are younger children at home, that most
of the others in the family will follow. Some
records I have studied show that six, eight, or even
ten children from one family have attended the

[116]

DEGENERACY IN THE MAKING

same school. It is of interest, moreover, to note —
though the fact is not relevant to our discussion —
that the subnormal parents were in some cases
comparatively well off, one father owning five
apartment houses, though all his children went to
the school for subnormals.

No, I cannot place any faith, on the basis of all
the evidence I have been able to collect, in the
theory that feeble-mindedness is a simple Men-
delian problem, a trait produced by a single pair
of recessive genes — in other words, not inherited
from a line of feeble-mindedness. There is no
case known in which a pair of feeble-minded
parents, themselves the offspring of feeble-minded,
have produced a normal child ; nor is there, to my
knowledge, any record of any pair of feeble-
minded persons who have come from normal
parents and who have married and produced nor-
mal offspring, since when such persons are born
of normal parents the latter see to it that their
offspring do not marry.

I have written no case and no record, but my
negative applies only to researches in our own
country. I do know of one exception, and the case
is a rare type of feeble-mindedness that may, it
appears, spring from a single pair of recessive
genes. The Swedish investigator Torsten Sjogren

THE CASE FOR STERILIZATION

found two types of amaurotic idiocy in an isolated
valley in Sweden. This is a rare mental defect
associated with progressive blindness and paraly-
sis. He found that both forms were undoubtedly
transmitted by "carriers" — persons who themselves
are normal but who may pass a defect through
to another generation. If it is this exceptional
kind of subnormality that the Journal of Heredity
writers were using as a basis for their assumption,
it is far too slender a basis, since this is not the type
of feeble-mindedness that is giving humanity so
much concern to-day, especially in our country.

As regards the inheritance of insanity, we know
less than we do about the inheritance of feeble-
mindedness. As our knowledge grows, we shall
very likely agree that environment and heredity
working together account for mental disease, and
that in certain specific forms one exerts more in-
fluence than the other does. Already we have such
studies as that made by Kraepelin, who tells us
that an investigation of his patients in Heidelberg
disclosed the fact that, in 80% of the cases of
manic-depressive insanity, heredity was the pre-
disposing factor; while in an investigation of 1,000
cases of dementia praecox he found hereditary ab-
normalities in 53.8% of the cases.

Likewise Siimner, investigating hereditary in-
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DEGENERACY IN THE MAKING

fluences in manic-depressive insanity, found heredi-
tary taint in 84% of a series of 650 cases. Others
have made similar investigations and found a
smaller percentage, and yet others have come to the
conclusion that the percentage is higher.

We have not considered epilepsy and its mode
of inheritance. Ten years ago we were much more
certain about its cause than we are to-day. That
some forms of it are hereditary is not denied, but
to lay the blame for all epilepsy on heredity is
now no longer the practice. Myoclonus epilepsy,
a rare form, is transmitted as a simple Mendelian
recessive. Perhaps other forms are, too. Time
alone will tell.

Right here, at any rate, a word of warning is
in order to those who can find heredity responsible
for all degeneracy. It would not be at all difficult
to prove that the tendency to automobile accidents
runs in families : all that we should need to do is
to assemble as many records as possible of cases
where a number of representatives of the same
family were killed in automobile accidents, and
we should have proved our case — yes, proved it in
the same way that a lawyer proves his, but not
in the way a scientist proves a fact.

Much of the early work on the inheritance of
epilepsy was done in this way. There was epilep-

THE CASE FOR STERILIZATION

tic Johnny. There was his Aunt Hannah, also epi-
leptic, and there was perhaps Cousin Nellie.
These stood out in his pedigree, showing that his
epilepsy was probably hereditary. That kind of
thing was a simple matter to study. But could
we turn the picture around and, on the basis of
what we knew about the pedigree, predict before
Johnny's birth that he was going to be epileptic?
No, we could not.

We have to assemble large numbers of cases and
determine whether, on the basis of them, a definite
percentage is found which indicates the inherit-
ability of the trait. Studies made in this way do
not indicate that epilepsy in all its forms is in-
herited; but they do show that there is a greater
chance for children to be born with the deficiency
where there are cases of it in the families than there
is for them to have epilepsy where there is no
family history of it in their antecedents.

In the case of mental disease, as well as mental
defect (feeble-mindedness), we frequently find
that the trait itself is not transmitted, but that some
other trait akin to it is passed on, almost as though
one characteristic had the ability to become trans-
muted into another. For example it is not at all
uncommon to find a family with a number of
feeble-minded children, and a parent who is epi-

[120]

DEGENERACY IN THE MAKING

leptic. In mental disease, we would do better
oftentimes to think of it as the interaction of
heredity and environment, and consider that the
predisposition rather than the disease is inherited.
But whichever is inherited — predisposition or dis-
ease— is it not better to weed out the types of minds
that have low breaking-points, and encourage the
types that can stand all kinds of mental strain with-
out succumbing?

Our final consideration is the rate at which the
subnormal group is reproducing. If as a group
the feeble-minded are having more than 3.5 chil-
dren to a family, they are increasing; if less, they
are decreasing. One American figure and one
English may serve to answer this question. In
my New Haven study I found the average to be
7.1 children, which means (as shown by our figures
of survival averages on page 107) that the group
is practically doubling with each generation.

Dr. A. F. Tredgold, the celebrated English ex-
pert on the Royal Commission on the Feeble-
minded, says :

I have pointed out over and over again
that whilst the average born in a family
throughout the whole community is four,
the average in these degenerate stocks is

[121]

THE CASE FOR STERILIZATION

seven [the same as found in the New
Haven study], and there is not the slight-
est doubt that a very large proportion of
the progeny will go to swell the ranks of
the socially inefficient.1

To sum up, these facts are important in any
study of the desirability of sterilization for the
feeble-minded: that those who are in institutions
and are likely to remain there need not be steri-
lized since they are not free to reproduce; that
any who are likely to be released either tempo-
rarily or permanently ought to be sterilized to pre-
vent their continuing their kind ; that the number
of feeble-minded is increasing; that the mere fact
that a person has not been an inmate of an institu-
tion for the feeble-minded is no proof that he may
be considered "normal"; that there is, outside of
our institutions, a vast reservoir, somewhere, which
is at present turning out feeble-minded persons.
This reservoir is our borderline group, consisting
of many millions of individuals. They are the chief
producers not only of their own type, but of the
lower grades as well.

1 Mental Deficiency, 4th Ed., London, 1922, pp. 14-15.

[122]

CHAPTER VIII

A PAGE OF HISTORY

CHAPTER VIII

A PAGE OF HISTORY

More than 16,000 persons have been sterilized
in our public institutions since the practice first
became authorized by law. Sterilization for other
than eugenic reasons, however, had been in use in
various parts of the world for thousands of years
before that time. In the Near East and elsewhere
men have been rendered sterile in order to make
them safe to have about the court and the mon-
arch's wives, or to render them docile as slaves,
or to prevent racial amalgamation. The first to
be sterilized were the eunuchs, the method being
castration. Similarly, the male members of cap-
tive tribes were castrated on becoming slaves, and
their women bore children to the conqueror.
The difference between the thought that caused
these early sterilizations and the modern theory is
marked. The early ones were made wholly for the
exploitation of human beings by their fellow men.
The modern ones are performed with due regard
for human rights and for the betterment of the
human race.

THE CASE FOR STERILIZATION

In the United States, before the period of agita-
tion for State laws, a number of far-sighted per-
sons were urging castration as a sterilizing
procedure. To-day, though we may credit them
with vision, we cannot praise their choice of
method. For instance we find, in 1898, the trus-
tees of the Kansas State Institution for Feeble-
minded Children approving by resolution the work
of Dr. F. Hoyt Pilcher of that institution, who had
castrated forty-four boys and fourteen girls over
a period of years. Public opinion took sides in the
controversy that followed, and the practice was
stopped. In 1897 the State of Pennsylvania was
debating the subject at the instance of Dr. Martin
W. Barr; so was Massachusetts, led by its pioneer
in the care of epileptics, Dr. Everett Flood. But
a Texas physician, Dr. F. E. Daniel, had some-
what anticipated these men by publishing in 1893
a long article entitled "Should insane criminals or
sexual perverts be allowed to procreate?" From
1899 onward for some eight years Dr. H. C. Sharp
of Indiana sterilized patients who were "guests of
the State." In 1905 the Pennsylvania legislature
passed the first law, but the governor vetoed it.
Indiana led in the first actual passage of a law, in
1907. By 191 1, when the Indiana governor threat-
ened to cancel the appropriation of any State in-

A PAGE OF HISTORY

stitution that adopted the legalized practice, 873
had been sterilized. From the time the law was
passed up until 1925 only 120 vasectomies were
performed ; for some reason the surgeons got wary
about operating when the law allowed it, though
they had not hesitated when it didn't. Twenty-
seven States have, from 1907 to the present date,
passed valid laws authorizing sterilization, and
others will undoubtedly legislate this year.1

The Superintendent of the Eugenics Record Of-
fice, Dr. Harry H. Laughlin, has been of the
greatest assistance to the legislators of many States.
To him they have turned for information in their
endeavors to get sterilization laws enacted. Dr.
Laughlin was the author of the first formal book
on the subject, Eugenical Sterilization in the
United States. It is to the foresight of Chief Jus-
tice Harry Olson (who established the Municipal
Court in Chicago) that we owe the publication of
this epoch-making book. Judge Olson had always
been interested in the eugenics movement and was
for some years a director of the American Eugenics
Society. It was he who established the first psychi-
atric clinic in connection with any court. His
backing made it possible for the work to be pub-

1 See Appendix C for table showing sterilization figures for
the States having laws.

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THE CASE FOR STERILIZATION

lished, and his public addresses on the subject
helped the book to succeed. Though now out of
print, the book, as well as its author, has had a
profound influence. Dr. Laughlin's correspond-
ence with interested legislators and laymen has
been voluminous. In 1916 he wrote a smaller
work, bringing the study down to date. Thou-
sands of copies have been distributed by the
American Eugenics Society along with a great deal
of other reading matter and scientific information
to all who asked for material.

The American Eugenics Society has never in-
itiated campaigns for the enactment of such legis-
lation; it has been too busy giving help to the
various people all over the country who were the
willing instigators and local propagandists in their
own States. I emphasize this point because so many
persons have had the notion that extra-State in-
terests have sometimes interfered to exert what
these critics felt to be a diabolical influence on the
progress of the movement. Such, however, has
never been the case. When asked to do so by in-
terested people who were willing to work, the
Society has sent persons to testify, and has for-
warded booklets such as The Eugenics Catechism
and Dr. Laughlin's work, with perhaps a pam-
phlet or two dealing with related subjects. These

A PAGE OF HISTORY

would be distributed by interested members of the
legislature, and the others would find copies on
their desks when they took their seats on the day
when the case for sterilization was to be heard.

So much for beginnings. The next step forward
was taken by Mr. E. S. Gosney, a well-known Pa-
cific Coast attorney, and the noted biologist Dr.
Paul Popenoe, who together initiated the series
of studies to which I have so often referred in
earlier chapters. The material they gathered was
obtained through the use of questionnaires which
the authors sent out to California physicians and
surgeons known to be in touch with sterilized pa-
tients, and of other questionnaires sent similarly
by the superintendents of State hospitals for the
mentally diseased to as many of their former pa-
tients as could be reached. Besides these avenues
of information, the Los Angeles Obstetrical So-
ciety, at Mr. Gosney's instance, undertook an in-
vestigation of sterilization in private practice,
involving 420 cases of the sterilization of women.
Finally, a good deal of first-hand information was
secured through field workers and also from state-
ments made by sterilized patients to their surgeons.
Some of the figures that emerged from these studies
have been cited earlier in this book. The resultant
material appeared from time to time in various

[129]

THE CASE FOR STERILIZATION

scientific journals, and reprints were sent out when
requested. Eventually the two men summarized
their findings in an excellent treatise called Steri-
lization for Human Betterment? which has had a
powerful influence on the progress of the move-
ment.

Up until 1931 the movement was promoted by
public-spirited men and women of all religious
faiths ; but in that year an encyclical of the Pope
arrayed the Roman Catholic Church against it.
This attitude is of course regretted by all those
who are advocating the benefits that sterilization
will bring to society; yet they know that the cause
is a noble one, supported by the soundest scientific
principles as well as by the highest ethical consid-
erations, and they believe that when it is correctly
understood it cannot fail to appeal to every in-
telligent, sensible, and forward-looking person in
the community.

Practically all of the Jews with whom I have
discussed sterilization have been in favor of it.
This includes many eminent rabbis, but they also
are liberals. It is doubtful, however, whether the
orthodox Jew will align himself with those who
favor the practice; a few of them have recently
publicly opposed it. According to my friend, Dr.

1 New York, 1929.

[130]

A PAGE OF HISTORY

David de Sola Pool, upon whom I have relied for
much information regarding the ancient teachings
of the race, the orthodox Jewish rabbinate is the
official interpreter of Jewish traditions and it
would be indeed difficult to obtain its favor for
sterilization. This, he shows, is the reason : vasec-
tomy is one of the three methods of sterilization
forbidden in the official Jewish legal code, the
Shulchan Aruch.

Says Rabbi Pool, "The oldest interpreter of the
Bible leaves no doubt as to this. In Josephus An-
tiquities IV, 8, 40, in the summary of the Laws of
Moses it is written, 'Let those who have made
themselves eunuchs be held in detestation; avoid
the company of those who have deprived them-
selves of their manhood, and of that fruit of
generation which God has given to men for the in-
crease of our kind. Let such be driven away, as if
they had killed their children, since they have
destroyed beforehand what would procure them.
For evident it is that while their soul has become
effeminate they have also transfused that effemi-
nacy to their body. In like manner do you treat
all that is of monstrous nature when it is looked
on ; nor is it lawful to geld either men or any other
animals.' Surely a clear and emphatic enough
statement of the case.

THE CASE FOR STERILIZATION

"The rabbinical elaboration of this fundamental
Biblical prohibition is as follows : 'One who is con-
genitally sterile is not forbidden to marry, but one
who has been made sterile, whether through opera-
tion or accident, is so forbidden.

" ' It is forbidden to give any man or any animal
any drug which will sterilize, but it may be given
to a woman on the authority of a physician. [Tal-
mud Sabbath III.]'"

So it would seem that even the orthodox Jew may
favor female sterilization, but not male. Here is
a very commendable thing about the Jews: they
look upon their laws as applying to Jews alone.
Their religious laws, moreover, where public
health is concerned, have been in accord with scien-
tific principles. Rabbi Pool says, "While the Jew-
ish law does not allow the Jew to make a capon,
it has no objection to a Gentile doing this. The
same principle, it seems to me, would apply to
whether a Jew would object to others availing
themselves of sterilization."

Another obstacle in the way of progressive legis-
lation on the subject is the attitude too often as-
sumed by the legislators themselves. As with
birth-control laws and others of the kind whose
object is the betterment of the race, so our pro-

[132]

A PAGE OF HISTORY

jected laws for authorizing sterilization are too
commonly debated emotionally or politically
rather than in a spirit of objective inquiry. I
myself have attended so many such hearings on
these measures that I have almost given up hoping
that they are ever likely to be considered on their
merits. As every observer knows, too many of our
legislators to-day approach the business before
them in the light of its potential influence on votes.
The same thing applies to getting such laws ad-
ministered when once they are enacted. In most
cases appointments to the staffs of institutions are
political appointments. Then, if the boss gets com-
plaints that a number of his voters are opposed
to the administration of the sterilization law, he
quickly passes the word to the superintendents;
and superintendents have a notable faculty for
keeping an ear to the ground. Herein probably
lies the reason why some of our existing steriliza-
tion laws are put into practice so little. The qual-
ity of statesmanship — i.e., the power of envisaging
the true worth of any movement to improve future
generations — is conspicuously lacking in our legis-
lators and our administrators alike, as regards their
attitude toward legalized sterilization. If you
doubt this, just ask any of the more intelligent mem-
bers of your State legislature. Until public opin-

[133]

THE CASE FOR STERILIZATION

ion is so thoroughly roused that a larger bloc of
voters demand legislative action, and administra-
tive follow-up, the situation is likely to remain as
it is now.

In Canada and in Europe sterilizations have
been fewer than in our country. Until a year ago
only one Canadian province had a sterilization law
— that in Alberta; but in April, 1933, British Co-
lumbia passed one, and judging from the corre-
spondence on the subject that has been passing
between these two and the other provinces it will
not be long now before sterilization will be effec-
tive in all but the Roman Catholic provinces. Al-
berta has sterilized more than 300 in the five years
since its law was enacted, all operations being on
the voluntary basis.

In 1907 Switzerland sterilized the first patients:
two women, 25 and 36 years old respectively, and
two men of 31 and 32. All these were castrated,
and they were subsequently, with one exception,
respectable members of society; one of the men
committed petty thefts, but his sexual offenses
ceased. The work has gone on in that country ever
since, with modern methods in use.

Denmark passed a law in 1929, under which 54
persons have been sterilized, all by castration —
which is very remarkable in view of the fact that

[134]

A PAGE OF HISTORY

this type of operation is prohibited by the existing
penal code of the country.

In England the Eugenics Society, headed by
Major Leonard Darwin, a son of the great Charles,
is doing excellent work in bringing home to the
people the need for sterilization. In 1930 the
Society sent Mrs. Cora B. S. Hodson to our coun-
try to make a study of the subject and to report not
only to England but to Germany and other coun-
tries as well. She made an exhaustive inquiry,
gave many lectures which were heard by thousands
of Americans from coast to coast, and went back
home full of information and enthusiasm. As this
is being written, England has had a "voluntary"
law introduced for legislative action, based upon
a study made by a committee of scientists.

The latest word on the subject has come from
Germany. Under the dictatorship of Adolph Hit-
ler, a compulsory law has been passed with his
approval. I have had considerable correspondence
with certain German scientists who ever since the
War have been enthusiastic advocates of steriliza-
tion, and I am informed that before the subject
came to the attention of the present authorities
there had for many years been agitation for a vol-
untary law. We must remember that Germany
has long known more about her defectives and the

[135]

THE CASE FOR STERILIZATION

nation's health in general, both physical and men-
tal, than most other countries do about theirs, and
that she has been twenty years ahead of the United
States in psychiatry and somewhat ahead of us in
applied psychology. Much of our best informa-
tion on the mind has come from Germany; and
even before the War, that country had figures on
her population that put ours to shame. To realize
how much attention the Germans have given to the
study of heredity for many years, one has only to
look over the remarkable list of books dealing with
the inheritance of mental and physical traits that
have come out of Germany. While we were pussy-
footing around, reluctant to admit even that in-
sanity of certain sorts runs in families, the
Germans were calling a spade a spade. True, they
did export a few pseudo-scientists who on Ameri-
can lecture tours told our people that there is
"nothing to heredity." But I have often suspected
that their real reason for coming over was that
they knew they would find less opposition here to
their ideas because we had, relatively, so little
knowledge of the subject. To-day these same men
are not enjoying their former popularity and pres-
tige among us. On the other hand, men like Kahn
(now of Yale) and Kraepelin were and are capable
leaders who spoke plain and recognized inherit-

[136]

A PAGE OF HISTORY

ance when they saw it; and these men especially
have exercised an undoubted influence on the atti-
tude of the German leaders to-day.

The 400,000 known defectives in Germany who
become subject to the new law are about equally
divided into men and women, and they have been
listed as follows in the official inventory, according
to the Associated Press despatch from Berlin at
the end of December, 1933. The law applies to
hereditary defects as follows :

(1) Feeble-mindedness, tentatively esti-
mated at 200,000 persons

(2) Schizomania, 800,000

(3) Insanity, 200,000

(4) Epilepsy, 60,000

(5) St. Vitus' dance, 600

(6) Blindness, 4,000

(7) Deaf-mutism, 18,000

(8) Serious physical deformity, 20,000

(9) Chronic alcoholism, 10,000

And this represents but a small beginning, we are
told ! Though not all of us, probably, will approve
of the compulsory character of this law — as it ap-
plies, for instance, to the sterilizing of drunkards
— we cannot but admire the foresight revealed by

[137]

THE CASE FOR STERILIZATION

the plan in general, and realize that by this action
Germany is going to make herself a stronger na-
tion. No one can tell now, naturally, how the law
will work out in practice. By its very stringency
it may defeat itself; or, on the contrary, it may
prove to be one mighty step toward the creation of
a better German race. In any event, we in this
country need have no fear lest any similar whole-
sale measure be adopted, since we are not living
under a dictatorship.

American Jewry is naturally suspecting that the
German chancellor had the law enacted for the
specific purpose of sterilizing the German Jews,
but I believe nothing to be further from the truth.
The German law provides for the sterilization of
hereditary defectives only. It safeguards the rights
of every individual, and where it sterilizes it will
not maim. The measure is solely eugenic in its
purpose, and were it not for its compulsory char-
acter it would probably meet with the approval of
all who are free from religious bias.

Undoubtedly we shall now see a wave of popu-
lar sentiment sweep the world. Already a number
of countries that have not yet actually passed any
laws are manifesting a vivid interest in the sub-
ject. The interest of the Soviet governments in
eugenic measures is well known. Russia has le-

A PAGE OF HISTORY

galized abortion, so that any woman (with certain
limitations) may have it performed for a small
fee by a government surgeon. We may expect
sterilization laws to be enacted there before long
if the interest manifested by Russian scientists and
legislators is any indication. The Japanese, too,
are in close touch with the situation. In 1929 the
American Eugenics Society sent Professor Ros-
well H. Johnson to Japan to study the eugenic
problem there, and he returned with the impres-
sion that the Japanese are as keenly alive to the
subject as are the people of almost any other coun-
try. Besides these examples, the following are now
considering laws, already proposed and drafted :
Tasmania, New Zealand, Finland, Norway, and
Sweden. Sterilization and race betterment are
indeed becoming compelling ideas among all en-
lightened nations to-day.

CHAPTER IX
HOW MANY OUGHT TO BE STERILIZED?

CHAPTER IX

HOW MANY OUGHT TO BE STERILIZED?

The subject of this chapter is the number of per-
sons in the United States who, according to various
estimates, need sterilizing. The persons whom so-
ciety could do without are more numerous than
those whom it should sterilize. If in one fell
swoop we could eliminate all our useless degen-
erates, incapable of anything beyond a kind of gross
animal happiness, if we could awaken one morn-
ing and find all these gone in some mysterious but
painless fashion, what class of persons would we
fix on to be the ones eliminated?

Because we know that any nation is great accord-
ing to the kind of people who compose it, because
we know that persons with good intelligence and
well-balanced temperaments make the best neigh-
bors, it is quite likely that most of us in choosing
would start from the top and work downward. A
little thinking, however, would suggest that the
better method would be to start eliminating at the
bottom. We should go to the institutions for the

[143]

THE CASE FOR STERILIZATION

feeble-minded and look at their inmates. The
first ones to be picked out would probably be
those of so low a grade as to be hardly better
than human vegetables. It would require no
divine ability to decide on these. Next we might
select the imbeciles, who can be taught to use their
handkerchiefs and to perform other little common-
place acts, but nothing more. By this time we
should have a very long list — something like
60,000 inmates of institutions, our very lowest
grades of intelligence; but we should have made
only an infinitesimal dent in our population. If
we were then to add to our list all the hopelessly
insane we should be adding approximately another
60,000. But what would this amount to, in a
nation of 120,000,000 persons? Practically noth-
ing. Moreover, we should have to admit that all
these unfortunates will probably stay in institu-
tions for the rest of their lives anyhow, and so
wouldn't reproduce, so why should we worry about
them? Well, we shouldn't worry very much, ex-
cept on the ground of the money they are cost-
ing us.

Our next step, then, would have to be out into
general society. Now if we were bent on selecting
all the persons whom society would be better off
without, we should find a good many millions of

[H4]

HOW MANY OUGHT TO BE STERILIZED?

them — bungling their work, existing meagerly
when times are good, and living off the rest of the
population when times are bad. Undoubtedly so-
ciety would be better off without such, though the
assertion has been made that we need them for our
drudgery — for the "dirty work" of the world.
This assertion will be discussed later under the
objections commonly raised to sterilization.

The question would now arise, How far up in
the intelligence scale are we to go? The Army
mental test results showed that the white men in
the American draft for the World War could be
classified as to intelligence by the following per-
centages (in round numbers) :

4 % very superior

8 % superior

15.2% high average

25 % average

23.8% low average

17 % inferior

7.1% very inferior

They showed also that half of our adult population
is below the mental age of 13.2— i.e., the age of a
normal bright boy of thirteen. It was a distressing
revelation, and its bearing on our present interest
is that, if we put our lower limit of desirability at

[145]

THE CASE FOR STERILIZATION

thirteen mental age, we should be considering the
sterilization of half our fellow-countrymen! The
age of ten is by some psychologists regarded as the
line of demarcation between the dark and the day-
light of usefulness. Men and women whose minds
have never grown older than that of a normal child
of ten require more supervision and assistance at
any work they do than the product of their work
will pay for. Time was when a person of this
mental age could be taught to sit at a punch press
and feed it, but the need for this sort of work is
decreasing.

There are several ways of estimating the num-
ber of feeble-minded persons. The Army mental
tests, though often criticized, do nevertheless fur-
nish a reasonable index of mentality, and they show
us that 4,800,000 men in the white draft had an
I.Q. (intelligence quotient) below .70. The intel-
ligence quotient is arrived at by dividing the
mental age of the person by his chronological age;
as, for example, a young man of 19 whose mental
age is only 13 has an I.Q. of .68, and a man of 23
whose mental age is 15 has an I.Q. of .65. This
group of 4,800,000 white American adults, there-
fore, with an I.Q. of .70 have less than three-
fourths of the intelligence they should have to be
called normal. Because an I.Q. of .70 means a low

HOW MANY OUGHT TO BE STERILIZED?

mental age, it is fairly well agreed that persons
with any less intelligence than this are incapable
of getting along without an over-costly amount of
supervision.

The figures emerging from the Army tests are
roughly paralleled by the conditions found in New
Haven during the study of the 5,000 children who
had been in the schools for subnormals. All these
were mental-tested so that there was no guesswork.
The tabulations showed that slightly over 5% of
New Haven's citizens are feeble-minded. If this
condition is typical of the whole country, we shall
have to estimate the number of our feeble-minded
at 6,500,000.

The Negroes in New Haven furnished six times
as many subnormals as did the native-born whites,
and the Negro population of that city is probably
no less intelligent than the rest of the Negro popu-
lation all over the country; if anything, it may be
higher, since some students hold that a Negro has
to have more intelligence and gumption to migrate
from his Southland than he needs to stay in it. If
this is so, something like a eugenic selection has
taken place. Let us hope, however, that the New
Haven figures are not typical. The book Army
Mental Tests by Yoakum and Yerkes has this to
say:

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THE CASE FOR STERILIZATION

The comparison of Negro with white
recruits reveals markedly lower mental
ratings for the former. A further sig-
nificant difference based on geographical
classification has been noted in that the
northern Negroes are mentally much su-
perior to the southern.

Thus, if we add the Negro total of feeble-mind-
edness to the white, we raise our number still
higher. Even if we do not, however, there is an-
other addition that we cannot avoid making: the
4,800,000 persons in the United States who before
they die will be classified as insane. Lest any one
doubt this statement, here are some facts. In our
asylums there are 300,000 inmates at any given
time, and the turnover is so rapid that two patients
are admitted for every one patient who is dis-
charged, 80,000 new patients being admitted
annually. Death also takes a good many. One per-
son out of every 25 becomes an inmate of a State
hospital for mental defectives during the course
of every generation; one family in every seven is
represented.

But no less an authority than Dr. C. Floyd Havi-
land, who was Commissioner of Health for New
York and director of the Manhattan State Hos-

HOW MANY OUGHT TO BE STERILIZED?

pital, estimated that there are five to six times as
many mentally diseased persons outside of institu-
tions as there are in them. If all were committed,
the number of our mentally diseased in institutions
would be 1,800,000.

Without doubt the foreign-born have had a good
deal to do with the size of these figures, and for
this fact we may largely blame our lax immigra-
tion laws. The foreign-born furnish in some cases
as much as six times as many feeble-minded as na-
tives do, while as for the mentally diseased the
foreign-born (averaging all nationalities) furnish
175 for each 100 native-born.

There are two-thirds as many mental defectives
confined in our public institutions as there are stu-
dents enrolled in the regular college courses in the
United States.

Suppose we look at the problem from another
angle. Let us think of the criminals. Do they
come from the best homes, or from inferior homes?
If we tend to pity the criminal because he has
come from the wrong kind of early environment,
let us ask what type of parents have produced that
environment for him? It is from the typical en-
vironment of the mentally low-grade that both our
city gangs and our criminals are derived. It is
these border-line elements that make up our slums,

THE CASE FOR STERILIZATION

and this is true in spite of the occasional exceptions
found in gifted writers and other artists; for the
latter do not as a rule emerge from people who
have spent three generations as slum-dwellers —
they are more likely to come from the families of
recent immigrants in whom the skimming process
has not yet begun.

If we could purge the country of our typical
slum elements, in city and country alike, what harm
would be done? Why would it not be well worth
while to include them in the group whom we are
weeding out of the population garden? And how
many of them are there? Nobody knows. This
addition to our list could hardly be counted exactly.

Including all the various types of less useful
social elements, we should probably be disposing
of the lowest fourth of our population ; and, after
the economic adjustment, we should hardly miss
them. But I am not here suggesting that all these
be sterilized wholesale, but merely that we make
voluntary sterilization available to them.

It is for this reason that I am somewhat in sym-
pathy with those who ask : Suppose in a few cases
we do sterilize some person who is not likely to
pass dysgenic traits on? Suppose we do make a
mistake occasionally and sterilize somebody whose
subnormality is due to accident and not to heredity?

HOW MANY OUGHT TO BE STERILIZED?

What's the difference? Whether we believe that
the subnormality is traceable to heredity or to
environment, what we want is good children in
good homes. Degenerate parents cannot bring
children up properly. What harm if they become
sterile?

Judge Harry Olson of Chicago, whom I have
mentioned before, was once asked to speak at an
important meeting. Ahead of his speech two other
numbers appeared on the program. First a woman
speaker rose, holding a bag, which she presently
opened, drawing forth some baby things. These
she held up, one at a time, while she told of the
good work that her Society was doing in rescuing
abandoned waifs, of the money that was needed
for their reclamation, and of how the homes in
which these children were placed were molding
their characters so that they would become fine
men and women. The good old appeal ! People
open their hearts and their pocketbooks when it
is made.

Following her, a man sang Henley's famous
poem, Invictus. Then Judge Olson was intro-
duced. He came forward, with that well-known
dignity, that calm, compassionate expression, and
for a moment stood silent. Then he said: "My
friends, my subject has been announced as The

THE CASE FOR STERILIZATION

Prevention of Crime. But I have just now de-
cided that I am not going to speak on that subject.
We have all heard a beautiful rendering of Hen-
ley's poem, and I am going to speak on a subject
that it suggests to me: 'I am not the master of my
fate — I am not the captain of my soul !' ' And
there followed an extemporaneous speech that will
never be forgotten by the audience that heard it.
Judge Olson was right: there are millions of
Americans who are not — never have been — the
controllers of their own destinies ; through heredity
or through environment they have all their lives
been "bound in misery and iron." And when I
begin to weigh this question of heredity vs. environ-
ment as a determining factor, I always think of
Judge Olson and of one other man. When Olson
— then Mr. Olson — was in the State Attorney's
office he was considered a prosecutor of great
promise. Contending against him was another
promising young man named Clarence Darrow.
Mr. Darrow has told me that Olson was the smart-
est prosecutor he ever had to meet; and Judge
Olson tells me that Darrow was the cleverest, ablest
defense attorney he ever argued against. In his
earlier days Olson was given to stressing heredity
as the predisposing cause of crime, while Darrow
insisted on environment; since then, each man has

HOW MANY OUGHT TO BE STERILIZED?

shifted his position somewhat. I mention these
facts as preface to the interesting coincidence that
Mr. Darrow — without dreaming that Judge Olson
had ever done so before him — also spoke once on
this same text: "I am not the master of my fate —
I am not the captain of my soul."

To say that to-day both men, having changed
their views considerably, hold that heredity and
environment are perhaps equally important as de-
terminants is only to say that they are probably
representative of the majority of us. It seems to
me immaterial whether we hold that a boy is a bad
citizen because he has inherited bad traits from his
forebears or whether we blame his childhood en-
vironment for these; in either case, if he is the
child of bad parents he has not had the right start,
and they ought never to have produced him. His
start must come from his parents, and whether his
subsequent useless or vicious life is the result of
germ-plasm or of their inability to rear him right
makes no difference : sterilizing them will prevent
their launching other potential defectives or crimi-
nals to burden our civilization.

In the case of such children it is too late to think
of their heredity or their environment if we wait
until they are grown. Since they did not "choose
good grandparents," as the first Oliver Wendell

[153]

THE CASE FOR STERILIZATION

Holmes advised us all to do, there remains now,
apparently, only the resource of sterilization if we
are to help future generations to be freed of the
effects of that bad heredity or that bad environment.
I say "apparently" because in subsequent chapters
I propose to show that there are other ways of
attacking the problem than any such wholesale
compulsory sterilization as is implied in the elimi-
nation of the ten millions of our population whom
we should be able to get along without.

CHAPTER X

WHAT HAPPENED TO CARRIE BUCK

CHAPTER X

WHAT HAPPENED TO CARRIE BUCK

In Virginia they sterilized Carrie Buck. But
before they got her sterilized, a storm of litigation
had risen and raged, not to be stilled until the Su-
preme Court of the United States handed down a
decision which made history.

In Carrie's case the operation was compulsory,
and what had to be established first was whether
or not she was feeble-minded. It was proved that
she was ; mental tests showed that though she was
1 8 years old chronologically she was only about
9 years old mentally. It then became relevant to
determine, as well, whether she had been socially
adequate. Her past record was therefore put
on file, proving that Carrie had never been self-
sustaining except under supervision ; that she had
had a baby who also was a mental defective ; that
her life thus far had been marked by untruthful-
ness, immorality, and prostitution. All things con-
sidered, the authorities maintained that they had
done the proper thing in having her committed as

[157]

THE CASE FOR STERILIZATION

a feeble-minded person under the laws of the Com-
monwealth of Virginia.

Then it was proposed, further, that the girl
should be sterilized. But sterilization, as per-
formed in our public institutions, is authorized
only in case an inheritable defect can be proved.
So the State detailed agents to study Carrie's ante-
cedents. They found that the identity of Carrie's
father could not be ascertained, though learning
facts about her mother was not difficult. Why?
Because her mother, Emma Buck, was an inmate
of the same institutional colony. The mother's
chronological age was 52, but she proved on test
to be slightly under 8 mentally. Before being com-
mitted, she too had been a prostitute, had had
syphilis, and had given birth to two sons before
Carrie. The agents reported, in addition, that the
family stock on the mother's side was typical of
"the shiftless, ignorant, worthless class of anti-
social whites of the South." Like Carrie's own
father, the fathers of her two half-brothers could
not be traced. The agents found that, although the
shifting habits of her class and family made it
almost impossible to learn as much of her back-
ground as they wanted to, they did learn a good
deal. She had been abandoned as a baby and
adopted when she was four by a Charlottesville

WHAT HAPPENED TO CARRIE BUCK

woman, who had given her all the education that
the backward child could absorb; Carrie had gone
as far as the sixth grade.

But in spite of this good environment Carrie
took to immorality. This was tolerated by her
foster-mother as long as she could stand it; but
when Carrie became pregnant that was the last
straw. The girl had demonstrated that she was
almost useless except under strict supervision and
certainly incapable of self-support or even of self-
restraint.

All these findings revealed the girl as not only
the daughter of a feeble-minded person but also
as the parent of a child who had inherited her
mental deficiency. In a word, Carrie had fulfilled
every requirement of the Virginia statute; so she
was ordered sterilized by the Special Board of
Directors of the State Colony for the Epileptic
and Feeble-minded, as required by law, on the
petition of A. S. Priddy, superintendent of the
colony. His reason? Carrie was at the moment
an inmate of the colony, and if she were to be dis-
charged she would go out as the potential parent
of still other socially inadequate offspring. He
said that she could be sterilized without harm to
her general health. Oral evidence was presented
before the Board, and it ordered the sterilization.

[159]

THE CASE FOR STERILIZATION

Then came the storm. Judge Bennett T. Gor-
don of the Circuit Court appointed a guardian for
Carrie. As is the usual procedure, he listened to
testimony, including that presented to the Special
Board and a deposition by an expert in heredity
who analyzed Carrie's case from that viewpoint.
The judge then affirmed the decision of the Special
Board. The case was thereupon appealed.

In the Virginia Supreme Court of Appeals,
Judge Jesse F. West sustained the statute, declar-
ing that "the act complies with the requirements
of due process of law," that it "is not a penal
statute" and therefore cannot "impose cruel and
unusual punishment," and finally that, because the
statute "does not deny the appellant . . . the equal
protection of the law, . . . the Virginia Steriliza-
tion Act is based upon a reasonable classification
and is a valid enactment under the State and the
Federal Constitutions." Before rendering his
considered opinion, Judge West listened to the
testimony of two institutional heads and two ex-
perts on heredity.

One of the latter, Dr. Harry H. Laughlin, Su-
perintendent of the Eugenics Record Office, testi-
fied that in the archives of that institution there
were many manuscript pedigrees of families with
feeble-minded members. These pedigrees, he

[160]

WHAT HAPPENED TO CARRIE BUCK

said, proved conclusively that both feeble-mind-
edness and other intelligence levels are in most
cases accounted for by hereditary qualities. "Mod-
ern eugenical sterilization . . . is a force for the
mitigation of race degeneracy which, if properly
used, is safe and effective. I have come to this
conclusion after a thorough study of the legal, bio-
logical, and eugenical aspects and the practical
working out of all the sterilization laws which
have been enacted by the several States up to the
present time."

Of the large amount of testimony offered, a few
points are worth special consideration. The super-
intendent of the institution in which Carrie was
confined made some points that will be remem-
bered and quoted more and more in years to come.

Q. Taking into consideration the years
of experience you have had in dealing
with the socially inadequate, and more
particularly with the feeble-minded, what,
in your judgment, would be the general
effect, both upon patients and upon society
at large, of the operation of this law?

A. It would be a blessing.

Q. Of course these people, being of
limited intelligence, lack full judgment
[161]

THE CASE FOR STERILIZATION

of what is best for them, but generally, so
far as patients are concerned, do they ob-
ject to this operation or not?

A. They clamor for it.

Q. Why?

A. Because they know that it means
the enjoyment of life and the peaceful
pursuit of happiness, as they view it, on
the outside of institution walls. Also they
have the opportunity of marrying men of
their mental level and making good wives
in many cases. . . . The strong reason
for the operation of the sterilization law
is that the State contemplates the deten-
tion of these women in the institution
during their child-bearing period of from
twenty-five to thirty years; and by sterili-
zation— an absolutely harmless operation
— within three weeks the end that would
be attained in twenty-five years would be
brought about. They are no worse off
when sterilized surgically than when
sterilized by Nature after being kept
locked up for twenty-five or thirty years.

Q. In other words, when segregated,
they are effectually prevented from prop-
agation?

WHAT HAPPENED TO CARRIE BUCK

A. Yes, sir. And there is another
matter to be considered: when you keep
these women locked up for twenty-five to
thirty years, the door of hope is closed to
them. They are incapable of getting out
and earning their own living.

Q. In other words, you have to train
them young, and if you postpone their
opportunities for training they get so they
cannot do it?

A. Yes, sir ; they become helpless and
lose confidence in themselves.

A large number of cases were cited in the court
to show that Carrie had had due process of law,
that no cruel and unusual punishment was con-
templated, that this was not a case of class legisla-
tion under the meaning of the law, that the State
had the power to enact legislation so long as it did
not deprive the individual of his or her constitu-
tional rights, that this operation was akin to com-
pulsory vaccination, and that there are manifold
restraints to which every person living in an or-
dered community is necessarily subject for the
common good.

Finally Carrie's case reached the Supreme Court
of the United States. It was then that Mr. Jus-

[163]

THE CASE FOR STERILIZATION

tice Holmes delivered his now famous opinion.1
Here it is :

We have seen more than once that the
public welfare may call upon the best
citizens for their lives. It would be
strange if it could not call upon those who
already sap the strength of the State for
these lesser sacrifices, often not felt to be
such by those concerned, in order to pre-
vent our being swamped with incompe-
tence. It is better for all the world if,
instead of waiting to execute degenerate
offspring for crime, or to let them starve
for their imbecility, society can prevent
those who are manifestly unfit from con-
tinuing their kind. The principle that
sustains compulsory vaccination is broad
enough to cover cutting the Fallopian
tubes. . . . Three generations of imbe-
ciles are enough.

But, it is said, however it might be if
this reasoning were applied generally, it
fails when it is confined to the small num-
ber who are in the institutions named and
is not applied to the multitudes outside.
1 Buck vs. Bell, 1927.

WHAT HAPPENED TO CARRIE BUCK

It is the usual last resort of Constitu-
tional arguments to point out shortcom-
ings of this sort. But the answer is that
the law does all that is needed when it
does all that it can: indicates a policy,
applies it to all within the lines, and seeks
to bring within the lines all similarly situ-
ated so far and so fast as its means allow.
Of course so far as the operations enable
those who otherwise must be kept con-
fined to be returned to the world, and thus
open the asylum to others, the equality
aimed at will be more nearly reached.

So Carrie was sterilized; Carrie, the feeble-
minded girl around whom such protection had
been thrown that before she could be sterilized her
case went to the Supreme Court of the United
States ; Carrie, the ultimate decision in whose case
paved the way for thousands of other unfortunates
to be relieved of part of the burden of their in-
firmities— the birth of unwanted children whose
coming, along with the inherited deficiency, is so
great a handicap that hope for them is impossible.

Carrie, poor unfortunate Carrie — little does she
know how greatly, if unconsciously, she has served
the world!

THE CASE FOR STERILIZATION

The case of Carrie Buck is not, however, alto-
gether typical. Naturally the courts are not always
thrown open to litigation whenever a sterilization
case is under consideration. Let us take the hypo-
thetical case of a father and mother who have a
daughter in an institution for the feeble-minded in
(let us say) Idaho. Mary is eighteen and has
shown that she can behave pretty well when she is
supervised. One day the parents get a letter from
the superintendent saying that he thinks it would
be wise to have Mary sterilized and then to let her
go home. What do they think?

Well, to tell the truth, they have never given
such a possibility any thought at all. Now they
remember that there are some boys in the neigh-
borhood who often used to come and see Mary
before she was committed, and they begin to won-
der whether, if she does come home, some of these
boys will be after her, and pretty soon they'll have
a baby on their hands to take care of. What does
the superintendent mean, anyhow, by "sterilized"?
They discuss the question, but without getting any-
where. So they decide to drive over and see the
superintendent.

He is a pleasant, kindly man, entirely ready to
explain anything in the situation that puzzles or
troubles them. They begin to question him. What

[i 66]

WHAT HAPPENED TO CARRIE BUCK

is this operation he is talking about? Will it hurt
Mary? Will it make her get fat? Will it do any-
thing to improve her mind? Will it make her less
interested in boys?

The superintendent assures them that the opera-
tion, which he describes very simply to them, will
cause Mary very little pain, that she will be given
the best care that the infirmary can provide, and
that she will not get fat as a result of it. It will
not, he admits, correct her mental deficiency nor
reduce her interest in boys ; but if ever a boy does
take advantage of her, if her feeble inhibitions run
away with her, there can be no result in the form
of a baby. Is this what the parents wanted to
learn?

Mother looks at Father, and Father nods back.
"Do you perform many of these operations?" he
asks, and is at once told that a great many are being
done right along and that the patients are happy
over the results. So after a little further discussion
the two say that they will go home and think it
over some more. In fact, the subject occupies their
minds and is the major theme of their conversation
for several days, till at length they come to a deci-
sion and write to the superintendent that they are
willing to have Mary sterilized.

The next step in the procedure is that the super-

THE CASE FOR STERILIZATION

intendent presents the case at the regular meeting
of the State Board of Eugenics. As prescribed by
law, this is composed of "the State Health Advisor
and the superintendents of all the State institutions
for insane, feeble-minded, and criminalistic."

The Board take the matter under advisement,
and after due consideration, again as prescribed by
law, they issue a statement that as a result of careful
inquiry they believe that Mary is likely to be the
progenitor of children who would be feeble-
minded and a menace to the State — probably,
indeed, wards of the State; that there is little likeli-
hood of any improvement in her condition; that
they therefore deem it advisable that she be op-
erated on ; and that they have received through the
superintendent's office the written consent of the
girl's parents.

Then the Board considers what type of operation
shall be performed, and orders salpingectomy.
The operation done, and the girl over her conva-
lescence, she is released to her parents. Mary can
now live at home, watched by her mother, more
contented perhaps than she was in the institution,
running around a good deal with the boys and
taken advantage of by them rather often — true;
but she never has a baby.

It may be interesting to consider the fees paid to
[i 68]

WHAT HAPPENED TO CARRIE BUCK

the surgeons who perform these operations, and
what the State is liable to in the way of further
expense. Most States allow the surgeon a fee of
$25 and refund their traveling expenses to the Board
members who act on the cases presented. With so
low a surgeon's fee, there is evidently little risk of
graft and no incentive for any surgeon to operate
in more cases than are strictly necessary.

In no two States are the laws exactly the same,
each State having provisions that apparently are
considered appropriate to its own conditions. Rel-
evant points are the density of its population, the
kind of arguments offered in the legislative houses
at the time of presenting the original bill, and the
period at which the bill is passed. In the future
there will doubtless be greater uniformity because
the proponents and authors of new bills will be
able to draw on the experience of other States.

CHAPTER XI

CHILDREN NOT WANTED

CHAPTER XI

CHILDREN NOT WANTED

If you know the subnormals in our population,
you know that they do not have children from
choice. They accept them because they do not
know how to avoid them; but they do avoid the
responsibilities of parenthood, frequently at the
expense of the community. The usual reason why
degenerates have children is because they cant help
it. If they knew how to prevent conception, they
would adopt the procedure as eagerly as they ac-
cept their weekly charity dole. Yet even they
have but to look around them to see that nearly
all intelligent persons are limiting their families.

Here is a table that Professor Huntington and
I made after studying the family sizes reported
by persons of various religious faiths, as listed in
"Who's Who In America." You can see that the
investigation has been a broad one, since actually
nineteen separate religious faiths have been in-
cluded.

[173]

THE CASE FOR STERILIZATION

Name
of Denomi-

Men in
"Who's

Estimated
children

Probable
great

nation

Who" per

per man

grandchil-

100,000

dren per

adherents

1,000

persons

Mormons

ii

5-3

IO,2OO

United Brethren. .

3

3-3

2,32O

Lutherans

8

3-3

1,950

Evangelicals ....

5

3-o

1,730

Brethren

7

2.8

1, 600

Reformed

13

2.9

1,580

Baptists

16

3-i

1,560

Methodists

18

2.9

i,455

Disciples

ii

2.8

i,45o

Christians

45

3-i

1,380

Roman Catholics . .

7

3-3

1,3*0

Presbyterians ....

62

2.8

1,230

Adventists

ii

3-o

1,190

Congregationalists

H5

2.7

1,125

Unitarians

1,185

2.9

1,025

Episcopalians . . .

156

2.8

910

Friends

3i

2.9

855

Jews

20

2.6

755

Universalists ....

39°

2.4

500

Take any class of society that you wish and you
will find that religion has very little to do with
family size.

The figures given above show, with the curious

[174]

CHILDREN NOT WANTED

exception of the Mormons, a difference of only 0.9
in the average number of children of eighteen re-
ligious faiths. In other words the difference is less
than one child per man, even allowing for the
greatest variation.

Another study on a smaller scale, a neighbor-
hood study made by the writer, surveyed a neigh-
borhood of high middle class and bore out very
accurately the results of the table made with Pro-
fessor Huntington. The figures did not represent
all the children that had been born, but only the
living children of mothers over forty-five. The
average was 2.4 children.

When we come to the low class social elements,
other factors indicate that religion seems to make
little difference in size of family. The reason is
that this class of people is too stupid to com-
prehend the physiology of reproduction, and too
shiftless to bother about learning contraceptive
methods. In many cases, when they do have in-
formation, they are too poor to buy good materials,
and in some cases too lazy or witless to use these
as they have been instructed to. I am convinced
that if such people could be sent to a hospital where
they could have a good two weeks' rest at public
expense, good meals, and all sorts of comforts that

[175]

THE CASE FOR STERILIZATION

they do not have at home, they would welcome
sterilization. Their major troubles would be over.

Case histories can be overdone, but because they
illustrate my point so very well, I want to tell you
about some families I have known.

As a preface let me recall to your mind that it
requires four children to perpetuate a family, and
also that the infant mortality rate among slum
people is prodigiously high. Now many people
feel that even subnormals should be permitted to
have at least two children, to satisfy the parental
instinct — though I assure you that most subnormals
would consider even two children a little more
than enough. But, assuming that subnormal cou-
ples were to have two children apiece, the high
infant mortality rate among them would force a
drop of fifty percent in their numbers each genera-
tion.

Well, there was that faithful, hard-working
woman who did our washing for several years.
Left a widow with five young children to rear, she
has spent a lifetime of drudgery and hardship, to
find herself at sixty a tired old woman entirely
dependent on the city for support. Of the three
children she has brought up to maturity, only one
is a comfort to her; and he has been unemployed
so long that he is a liability rather than an asset.

CHILDREN NOT WANTED

On several occasions she has said that if she had
it to do over again, with the information about
birth-control that she has picked up in recent years
she would have only one child. "It's them kids
that have kept me poor. Why I was blessed with
'em I don't know."

Another instance is that of a very high-class
couple who ought never to have had any children,
and have repeatedly told me so. In their case they
had had them because at the time they didn't know
how to avoid it. They have three children, of
whom two are insane and one is normal. The fam-
ily history proves that the two insane children
are unquestionably the products of unfortunate
heredity. Even though the chances were only one
in four that these fine people would have an insane
child, still the odds were against them and they
had two. Neither child will ever be any use to
society, and both will be perpetually cared for at
the expense of the family. The father has con-
fessed to me that having the one normal daughter
has not compensated for the two pathetic, de-
mented sons. He has since been sterilized vol-
untarily.

And now to go almost to the other extreme, con-
sider for a moment a family in Connecticut. It
stands as the best illustration I know of the fact

[177]

THE CASE FOR STERILIZATION

I am trying to bring out: that our degenerates and
our producers of degenerates do not want children,
but have them because they cannot avoid it. This
family is notorious. When the man's first wife
died, he sold her body to a medical school for $20.
When, years later, after he had remarried, he was
asked whether this were true he replied, "Yes, by
God, and I wish I could get that much for this
one!"

Children came to "bless" this man's mar-
riages. They were reared in squalor, and every time
a new baby arrived there was plenty of trouble in
the family. If they had not been assisted there
might never have been more than three children,
but undiscriminating charity provided royal care
for them. The father didn't even have to work,
for the town's charity organization paid the medi-
cal bills, confinement costs, food, heat, rent —
everything. It was "the life of Riley" for him —
that is, so far as freedom from responsibility was
concerned. But family life was never serene be-
cause of the constant wrangling over his sexual
relations with his wife, who was in constant dread
of becoming pregnant. But the babies came and
came and CAME, until there are now nine. When
the eighth child was coming the wife threw rocks
at her husband, and when the ninth was coming

CHILDREN NOT WANTED

she got so furious that she went out into the street
on a lovely spring morning when the tree depart-
ment was spraying the elms to kill leaf beetles, and
helped herself to a spoonful of arsenate of lead,
which she proceeded to stir into her husband's tea.
It made him very ill, but that was all.

Certainly after the first child in this family, not
one more was wanted by either the father or the
mother, and it was a crime against society that
more than one was born. A crime, yes, because
the children from that couple are of the same
caliber as their parents and have made no end of
trouble for the town to which they owe their whole
support. The girls have spread venereal disease,
and the boys have been in mischief time and
again.

One night a party of men, including the writer,
went coon-hunting. Besides one college professor
there were others from a good many walks of life.
Something in the course of our conversation led
up to a discussion of our sexual problems. I asked
the men to tell me exactly what they thought about
this question of having children; and, the unani-
mous opinion was that if a family had one child,
any others after that were accidents.

Only one man in the entire group refused to
answer then; he said he would give me his

THE CASE FOR STERILIZATION

opinion privately the next day. This was the
college professor, and his answer was highly in-
teresting. He said he thought that the people with
whom he associated wanted about four children.
This is just what I myself had gathered from ob-
servation of that class. I am convinced that the tide
has turned : that we are witnessing another revolu-
tion, greater than the economic even, a biological
revolution.

In The Builders of America Professor Hunting-
ton and I published some figures that were the re-
sult of a long study of what we concluded was a
new trend in society, and during the same year
three other investigators (Phillips, Woods, and
Lockeman in Germany) issued similar findings.
And all these findings are, I believe, valuable
straws showing us that the wind has changed and
is blowing not ill but good.

If one were to look at the entire population and
try to guess the birth-rates by groups on the basis
of innate social worth, one might expect to find
that those at the top have small families and that
as one went down the ladder of social fitness one
would find the families increasingly larger. Now,
in general, this is what we found — with one ex-
ception; and that exception constitutes the most
significant fact, I believe, that has been discovered

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CHILDREN NOT WANTED

in this field. Instead of finding that our top group
had the smallest number of children, we found
that they were having considerably more children
than were the group just below them. (Part of
our study consisted in having college graduates
rate their fellows as to success in life, and we were
interested to see that their criterion of success was
not wealth, that millionaires were often rated
among the lowest fifth, while missionaries were
placed in the first fifth of the group.) In all we
had 2,400 men to study and, when we had com-
pleted the tabulation, we found that the predictions
of population experts were all awry.

Percent Percent Percent

married, or having 1 having 3

married but or 2 cnil- or more

no children dren children

1 Most successful. . 4.9 6.1 9.0

2 Successful 5.7 7.4 6.9

3 Average 6.4 7.7 5.9

4 Relatively unsuc-

cessful 10.0 6.2 3.6

5 Least successful .. 12.3 5.4 2.3

For if we took the men of the top fifth we found
that they were more often married, more often
had at least one child, and had far more children
than the lowest fifth (or any other fifth, for that

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matter). When we came to consider any group
of intelligent persons, such as ministers, lawyers,
physicians, college professors, business men, engi-
neers, etc., the most successful had the largest fam-
ilies, and the trend was downward, with the
lowest fifth having the smallest families. (The
table appears on page 181.)

This proves that a movement in the right direc-
tion has started : instead of wanting one child only,
these high-class people whose children are a mat-
ter of choice rather than of chance have had more
than a single child. Another indication is found
in the answers given by a group of college students
who were asked to say how many children they
believed constituted an ideal family. The major-
ity of the men replied, "One boy and one girl."
This was in 1920. The question was asked again
two years ago of another and later class of male
students, and the reply this time was, "Four — two
boys and two girls." And again we are consider-
ing a group of highly intelligent young people.
Finally, similar evidence is derivable from the
study made by Dr. Florence Brown Sherbon of
the University of Kansas, Adolescent Fantasy as a
Determiner of Adult Conduct. Her findings seem
to me quite rich in significance. She asked her
freshman girls to define their marriage ideals —

CHILDREN NOT WANTED

the sort of husbands they hoped for, the size of
home, the number of children, and so on. Since
that time she has been able to watch what is hap-
pening to those girls now that they are women, to
see whether their hopes have been fulfilled; and
she learns that those "adolescent fantasies" have
to a considerable extent determined later choices,
have at least served as incentives in the choice of
mate, of type of home, of size of family. If we
may take these findings as at all typical, they prove
that our educated children may be at work making
a better America. These young people are going
to have larger families than their parents had.
The wealthier class in general is setting the fashion
of having larger families than were customary a
generation ago. One elderly social leader told me :
"In my day the woman who had only one or two
children was considered smart. To-day a well-
informed woman may have as many or as few as
she wants. To have several children and give them
a good start in life is getting to be the smart thing
to do." From my own observation I am coming
to believe that many of our fine young people to-
day are having enough children not only to per-
petuate the family but to insure its increase, and
I find it a welcome sign of the times. It fits in
perfectly with our ideas for a planned society.

THE CASE FOR STERILIZATION

Anything that we can do to encourage such people
to have large families, and anything we can do to
prevent large families among those at the lower
end of the social scale — both these ought to be
done, for they are of the utmost social value.

All the data above have a direct bearing on
sterilization. The prospect of somewhat larger
families among the highest class is encouraging,
but it cannot be looked to as an adequate counter-
poise to the unchanging increase among subnor-
mals. The differential birth-rate will long stay
with us as a grave problem. If — to look at it on
one side only, for the moment — our charity burden
is mounting, and if those who alone are able to
shoulder it are not increasing proportionately with
it, then it would seem that the more promptly we
take action the better; the sooner we give those
who want to help themselves the means to do it
with, the happier and certainly the more imme-
diate the effect.

But there is still another inference to be drawn
from the situation, especially from what has been
said about the favorable tendency of the upper,
successful stratum to have families larger than
those of the stratum just below them. It shows
that there are truly grounds for hope, if not for
optimism. It refutes the criticism that steriliza-

CHILDREN NOT WANTED

tion and birth-control are likely to be the instru-
ments of race-suicide. As for contraception, we
know that we cannot now take it away: it is an
established social practice. As for sterilization,
it must be established as a social practice far more
widely than it is now. Remove the pressure ex-
erted by the negative classes on the positive classes,
and this tendency toward adequate families among
the latter will expand until it actuates all the more
worth-while groups.

One final word : my use of such terms as worth
while and useful in connection with various social
classes must not be misinterpreted. No scientist
interested in racial improvement dreams of insist-
ing that we are to weed out until we have left only
the wealthy, or the professional, or the highly in-
telligent. The eugenic ideal is far from this. It
postulates rather a society in which the merchant
is a good merchant, the college instructor a good
college instructor — and the brick-layer a good
brick-layer; each capable of supporting himself
and his family and worthy to pass on his good
character and useful citizenship to his offspring
through both heredity and environment. We do
not ask that the street-sweeper shall buy bonds or
read Greek; we do ask that he spring from racially
adequate germ-plasm, and pass that germ-plasm

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THE CASE FOR STERILIZATION

along to all the little street-sweepers he fathers.
The best type in every social class must be encour-
aged to increase; the worst type — the defective,
insane, subnormal, and dependent — must be al-
lowed to die out. That is what sterilization is for.

[186]

CHAPTER XII

THE OBJECTIONS MOST OFTEN URGED — I

CHAPTER XII

THE OBJECTIONS MOST OFTEN URGED — I

For years I have been listening to objections
from various kinds of persons who are opposed to
sterilization. These I have recorded and classified
according to the number of times that I hear each.
Some of them are simple, terse, and pointed ; others
are long-winded and verbose. Some have an ele-
ment of reasonableness ; others are of the sort that
to the social scientist seem without reason. The
sixteen that are most often heard will be dealt with
in this and the following chapter.

The main, and most seriously taken objection
comes, as would naturally be expected, from the
Roman Catholic Church. Its head, Pope Pius XI,
has decreed against sterilization, notably in the en-
cyclical Casti Connubii issued in January, 1931.
That document is, in general, the expression of an
ideal that cannot but appeal strongly to any who
are eager for race betterment. More than a ma-
jority of its points, I imagine, find general support
among biologists and sociologists, as well as among

THE CASE FOR STERILIZATION

adherents of non-Catholic faiths; though its view
of sterilization can, of course, only encounter con-
siderable dissent.

"The Family Is Paramount/' Here is the sec-
tion of the encyclical that is most pertinent to our
subject :

That pernicious practice must be con-
demned which closely touches upon the
natural right of man to enter matrimony
but affects also in a real way the welfare
of the offspring. For there are some who,
over-solicitous for the cause of eugenics,
not only give salutary counsel for more
certainly procuring the strength and
health of the future child — which, in-
deed f is not contrary to right reason — but
put eugenics before aims of a higher
order, and by public authority wish to
prevent from marrying all those who,
even though naturally fit for marriage,
they consider, according to the norms and
conjectures of their investigations, would,
through hereditary transmission, bring
forth defective offspring. And more,

THE OBJECTIONS MOST OFTEN URGED

they wish to legislate to deprive these of
that natural faculty by medical action de-
spite their unwillingness; and this they do
not propose as an infliction of grave pun-
ishment under the authority of the state
for a crime committed, nor to prevent fu-
ture crimes by guilty persons, but against
every right and good they wish the civil
authority to arrogate to itself a power
over a faculty which they never had and
can never legitimately possess.

Those who act in this way are at fault
in losing sight of the fact that the family
is more sacred than the state and that men
are begotten not for the earth and for
time, but for Heaven and eternity. Al-
though often these individuals are to be
dissuaded from entering into marriage,
certainly it is wrong to brand men with
the stigma of crime because they contract
marriage, on the ground that, despite the
fact that they are in every respect capable
of matrimony, they will give birth only to
defective children, even though they use
all care and diligence.

Public magistrates have no direct right
over the bodies of their subjects; there-

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THE CASE FOR STERILIZATION

fore, where no crime has taken place and
there is no cause present for grave punish-
ment, they can never directly harm, or
tamper with the integrity of the body,
either for the reasons of eugenics or for
any other reason. St. Thomas teaches this
when, inquiring whether human judges
for the sake of preventing future evils can
inflict punishment, he admits that the
power indeed exists as regards certain
other forms of punishment, but justly and
properly denies it as regards the maiming
of the body. "No one who is guiltless
may be punished by a human tribunal
either by flogging to death, or mutilation
or by beating."

Furthermore, Christian doctrine estab-
lishes, and the light of human reason
makes it most clear, that private individ-
uals have no power over the members of
their bodies [other] than that which per-
tains to their natural ends; and they are
not free to destroy or mutilate their mem-
bers, or in any other way render them-
selves unfit for their natural functions,
except when no other provision can be
made for the good of the whole body.

THE OBJECTIONS MOST OFTEN URGED

Now any one who has ever undertaken to criti-
cize— or even to comment on — a religious subject
knows that, whatever he says, he will find himself
construed wrong in some quarters; and the same
applies to any attempt to refute a specific eccle-
siastical utterance. It is not my purpose in this
book to discuss or criticize the position taken by
the head of a great faith beyond the point where
it touches a scientific argument. With nothing but
respect for a viewpoint that is held by millions of
right living people throughout the world with no
animosity toward Catholics as Catholics, among
whom indeed I number some of my best friends,
I still urge that this question must, if it is to be dis-
cussed at all, be treated as a scientific question
rather than as a theological or even an ethical one.

The preceding quotation is given because it rep-
resents a point of view that, as a result of its pro-
nouncement, must be held by very many of my
fellow countrymen. If this viewpoint conflicts
with the laws now in force in many of our states
and with the belief on the part of many who are
not Catholics that these laws are just and necessary,
that they were enacted in the interests of public
welfare and that more of them should be put in
operation, it is the duty of all who believe in such
measures to state their belief as clearly and impar-

[193]

THE CASE FOR STERILIZATION

tially as possible. I refer, of course, to the steri-
lization laws that have been passed in a number of
states and to which I shall refer in another part of
this book. Sterilization, as its proponents see it,
is more than a moral question. It is an economic,
a social, a legal, a medical question and in the eyes
of many a help toward a higher morality.

The family is paramount? With this we may
agree. The family's claims are higher than the
states? With this we need not agree.

The encyclical stresses the importance of the
family and every social student will concur in this
emphasis. It is the very basis of our social life and
its preservation in the highest form is the aim and
the ideal of practically every civilized society
throughout the entire world. Proponents of steri-
lization believe that there are families and families
— good ones and bad. The first should, we urge,
be encouraged ; the second made impossible in the
future. There is nothing inviolable in the bad
family. One means toward the discriminatory
weeding out of undesirable families is sterilization.

The family is not paramount. It is an integral
part of the great unit which we call the state. Just
as the agriculturist works his farm, so the state or
family-culturist must cultivate its families by
seeing that the better type of individuals are pre-

[194]

THE OBJECTIONS MOST OFTEN URGED

served. The farmer goes about his farm continu-
ally alert to the need of culturing the best of the
living, growing elements. Here is a splendid corn
stalk. Its great size and high yield of grain show
conclusively that it has been able to do better in
a similar environment than many of its neighbors.
It is therefore preserved through its seed. Here is
a high testing cow. She must be preserved through
her posterity. Here is an outstandingly obnoxious
weed. It must be destroyed.

There are figs and thistles, grapes and thorns,
wheat and tares in human society and the state
must practice family culture.

"Sterilization Will Prevent the Birth of Genius."
Another objection that is raised against steriliza-
tion— and against contraception as well — is that it
will prevent the birth of genius. When the objec-
tion is leveled at contraception there is something
to be said for it, since contraception is practiced
by the sort of parents whose thirteenth child might
be Benjamin Franklin, the desirable sort of par-
ents. But there is no rational ground for the
objection in the case of sterilization since the pro-
cedure is urged only for the kind who ought not
to be the parents of one child, let alone thirteen.
Besides, the birth of genius is far more effectually

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THE CASE FOR STERILIZATION

"prevented" by a number of other factors already,
taboos that for the most part go unchallenged.
Take certain recognized marriage taboos, for in-
stance. Under one of these an unmarried woman
is not supposed to have children ; yet who can say
how many geniuses might not be produced if this
taboo could be removed? It is of course prepos-
terous to assume that it would be a wise sociologi-
cal step or correct ethically for unmarried women
to produce children on the chance that some of
them might be geniuses. But if the opponents of
sterilization really want to encourage the birth of
genius they might do well to consider this point.
Probably the top one percent of the population
produces as much genius as all the other 99 percent.
Speaking of thirteenth children brings to mind
the figures which have been publicized in regard
to the chances of survival according to birth rank.
These figures have been interpreted in various
ways, some of them rightly and some wrongly in
my humble estimation. As you will see in inspect-
ing them, the twelfth child has but little chance
to survive compared with the first or third. But
this entirely leaves out of consideration any ap-
proximation of the mentality of the family which
to-day produces twelve children, after they have
watched one after another of them die.

THE OBJECTIONS MOST OFTEN URGED

OF EACH 1000 CHILDREN :

115 die if they are first children.
200 die if they are sixth children.
300 die if they are twelfth children.
395 die if they are fifteenth children.

Probably the fathers and mothers who have had
the large families and have reared so few of the
children are not those who can be counted on to
produce genius. They would probably welcome
sterilization.

Besides, no one is suggesting the sterilization of
the kind of people from whom we may reasonably
expect geniuses to be born. The stock from which
genius springs is not degenerate, and it is the de-
generate whom it is proposed to sterilize. It is
admittedly possible (though rare) for genius to be
born from insane parentage; it is highly improba-
ble, to put it mildly, for genius to be born from
feeble-minded parentage. Great men have risen
from unfortunate environments; they have practi-
cally never risen from defective germ-plasm.

That the objectors on this score have little to fear
is proved by the studies of Dr. Louis Terman, Dr.
Catherine Cox Miles, and Professor Raymond
Pearl. Dr. Terman chose for study the thousand
most brilliant children in the California schools.
Among the facts discovered was this: that 66%

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THE CASE FOR STERILIZATION

of these children came from fathers who were
either professional men or engaged in the higher
types of occupation, and that only one child was
the offspring of unskilled labor — this father being
an ambitious man who had moved his family to
Berkeley so that the children could go to college,
and who had taken a job on a farm in order to
build up his health and also to tide him over while
he was looking for better work.

Dr. Miles made a study of the three hundred
greatest geniuses of history, and found that 80%
of them sprang from professional men and those
engaged in the higher occupations, and that only
i% came from unskilled labor.

Professor Pearl of Johns Hopkins studied the
biographies of all persons included in the Ency-
clopaedia Britannica important enough to be given
each an entire page or more, trying to determine
how many of these had sons who were also included
in the work. For instance, there were 63 philoso-
phers, of whom only 18 were recorded as having
married; but three of the sons from these 18 mar-
riages (a ratio of 6 to i ) got into the Encyclopedia.
Or, if we take the whole number of philosophers
treated — that is, 60 without sons, 3 with — the ratio
becomes 21 to i. Compare either ratio with what
we find in the population at large: does one son

THE OBJECTIONS MOST OFTEN URGED

among every 6 (or even 21) fathers get into the
Encyclopedia Britannica? "Like father, like
son." To conclude, I may say that there is as little
chance that you can breed genius out of subnormals
as that you can breed a Man of War out of a line
of Shetland ponies.

"We Know Too Little as Yet." The objection
heard next oftenest is that our knowledge of hered-
ity is not yet complete or accurate enough to war-
rant us in doing much sterilization, hardly more
than a few subjects here and there. To this I reply
merely that it isn't so. We have three ways of
deciding when sterilization is indicated. First, it
is possible to recognize the great majority of de-
generacy-carriers because they commonly exhibit
the signs. Second, a study of near kin will help us :
if we find that Grandmother and Uncle Rob, Aunt
Hattie and Cousin Randolph and Mother's brother
Bill were all feeble-minded, it is a safe bet that
Mother is a carrier; she inherits the germ-plasm
that has shown itself capable of producing a good
many feeble-minded out of the few chances that
it had to show what it could do. Third, we are
able to judge by the first or the second child in a
family. If a couple have produced two feeble-
minded children, and the index of near kin shows
that there has been a lot of feeble-mindedness on

THE CASE FOR STERILIZATION

both sides, then surely this couple should not be
allowed to launch any more children into the
world, even though the chances are only one in
four that the next child will be feeble-minded.
These three criteria give us ample ground on
which to set up a sterilization policy. In any in-
stance in which there might be doubt whether
sterilization is called for, the three could be ap-
plied simultaneously. If a family will apply them
to its own case it can readily decide whether there
ought to be any more children, or for that matter
whether the man and his wife ought to have any
children at all.

It is characteristic of those who protest that "we
know too little as yet" to urge us also to "wait and
see." Another usual corollary is that sterilization
isn't proved to be necessary at the present time.
This is a line of argument that we find presented
by Dr. J. H. Landman, whose position I should
like to discuss here. His book, Human Steriliza-
tion? indicates that he has made use of a valuable
contribution to the subject written by Dr. Neil A.
Dayton.2 The tables in Dr. Dayton's paper show

1 New York, 1932.

2 Mortality in Mental Deficiency over a Fourteen-year Period
in Massachusetts. Proceedings of the American Assn. for the
Study of the Feeble-minded, vol. 36, 1931.

[200]

THE OBJECTIONS MOST OFTEN URGED

that the idiots and the imbeciles have so high a
death-rate that there is but little likelihood of their
leaving enough descendants to perpetuate them-
selves as groups. We learned this also from the
California studies. But if Dr. Landman had read
Dr. Dayton's work carefully he would have seen
that Dr. Dayton says that the morons are the ones
who do live, and that the death-rate of males and
females averages about the same as that of the gen-
eral population. It has not to my knowledge been
suggested by advocates of sterilization, that the
idiots and imbeciles are perpetuating their kind
enough to increase as a group. We have already
seen that they come predominantly from the moron
and the border-line classes. This objection is
groundless.

"There is nothing to worry about — let us wait."
Another very important objection, but one not
so often raised, is that there is not much to worry
about. Dr. Landman mentions me as a pessimistic
eugenicist because I say that we are breeding from
the bottom. But the doctor forgets that I have
offered a remedy, whereas he thinks that nothing
much can be done about it. Which of us two, I
ask, is the pessimist? He would show that the be-
liefs and claims of eugenicists are more or less

[201]

THE CASE FOR STERILIZATION

groundless. But he has founded his belief on the
studies already dealt with — studies which assumed
that feeble-mindedness is a simple Mendelian char-
acter. He, like so many others, is an apostle of
the god WAIT. "Wait until we know more ; science
doesn't know enough yet." Every time I hear that
objection, I feel like taking my pen and writing :
"It isn't that science doesn't know enough. The
trouble is that the critic doesn't know how much
science really does know."

As a matter of fact, science never really will
know all we wish it could demonstrate to us. No
matter how much we progress, there will always
be those worshipers of WAIT. I can't help quot-
ing Dr. Leonard Darwin in this regard: "To prove
that our powers of doing good are limited to cer-
tain directions has always appeared to me to be the
feeblest of all excuses for neglecting to do such
good as is open to us!"

"The Wrong Persons Will Get Sterilized." In
line with the objection that we cannot know who
are the right persons to be sterilized is the next:
that the wrong persons will have the operation
performed on them. Who, we are asked, is going
to be selected to pass judgment? The objection re-
veals, on the part of those who make it, a less than

[202]

THE OBJECTIONS MOST OFTEN URGED

sufficient understanding of the procedure now fol-
lowed in the States in which sterilization is already
authorized by law. They raise in their minds a
bugaboo that has not and never could have any real
existence: the vision of some beautiful and culti-
vated woman, say, who somehow has incurred the
malice of a person of influence, and who now stands
before the bench of yet another vindictive and
powerful authority who is empowered to say
whether or not her line may go on. But nobody
who knows anything about the subject dreams of
setting up any legal procedure in which a risk like
this could arise. It is proposed to authorize and
permit the sterilization of the subnormal only, and
— as has often been said — "You can tell them walk-
ing down the street." You can. The feeble-
minded shuffle along, looking half-dead a good
deal of the time, wearing the expression of lethar-
gic despair that we visualize when we read The
Man with the Hoe. A few of them are content,
as animals are content; a few are even cheerful,
and able to do elementary tasks ; but even these for
the most part can be identified positively through
mental tests and observation.

Should sterilization ever become compulsory,
there will be practically no chance even then for
the wrong person to get sterilized. A committee

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THE CASE FOR STERILIZATION

of experts would examine any person whom it was
proposed to sterilize, and geneticists would pass on
the desirability of his being allowed to reproduce;
and the ultimate decision would in practically all
cases be as fair and as certain as any human deci-
sion ever can be. There would, of course, be
doubtful cases, and these would be given the benefit
of the doubt. The only persons actually sterilized
would be those about whom there has been no diffi-
culty in deciding.

"The Sterilizing Power Would Be Abused!'
Here is another bugaboo: there would be times
when the power would be abused. Well, there
might. But when one admits this, one is admitting
merely something that characterizes every aspect
of the police power of the state. Authority of any
kind is abused, often, but this does not deter the
body politic from vesting authority in certain offi-
cials whose job is the administration of measures
that in themselves are right. In anticipation of
this very danger, a part of the sterilization pro-
gram is the setting-up of a series of checks, such
as we have already seen at work in Carrie Buck's
case and that of our hypothetical Mary in Idaho.
Anyhow, what would happen to the official who
took advantage of his authority to order steriliza-

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THE OBJECTIONS MOST OFTEN URGED

tion for somebody who didn't need it? Public
attack would be prompt, and from high enough
quarters to assure him the loss of his prestige and
perhaps even of his job itself. Besides, the only
persons who ought to be given this power of de-
cision are scientists — trained to arrive at judgments
without fear or favor. Scientists take their work
seriously; anybody who has had any scientists
among his friends will bear witness to this. And
scientists are not going to risk making mistakes.

But what if they do? Suppose that once in a
while they do fall into error. Ah, it is here that
our existing laws have proved to be so wise. Be-
fore the operation can be carried out, the patient
has the full opportunity to present his case in court.
All sorts of safeguards are thrown about him, as
we saw in the Buck case. Already we have a good
many scientific men whom we can trust, and the
more sterilizations there are in the future, the
greater will be our proportion of high-grade men.
As you lop off stupidity and insanity you auto-
matically increase the proportion of ability.

Finally: we are willing to trust human lives to
our courts in the matter of capital punishment; why
not, then, in something far less serious? Certainly
an error in a sterilization order is less repugnant
to our notions of justice than the execution of an

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THE CASE FOR STERILIZATION

innocent man, a chance that we all face without
getting excited.

"Sterilization Will Increase Immorality." This
objection stands sixth on my list, in the order of
frequency. Well, one can easily see how a man
who has been sterilized might, now that he is rid
of the need for caution, tend to become sexually
promiscuous. But among the men of my acquaint-
ance who have had the operation I know of none
who has been affected in this way. Anyhow, isn't
it a pretty shameful assumption that the only rea-
son why men ever refrain from wrongdoing is that
they are afraid of its consequences? That we
would all of us rush into infractions of all the
Commandments if we weren't afraid of being pun-
ished? That there are no other, nobler motives for
behaving ourselves decently?

Besides, there are already available to the pro-
miscuously-inclined so many effective contracep-
tive methods that I doubt whether this "danger"
is any very new one. Yet I would not deny that
the objection has some weight. There is a possi-
bility, of course, that in some directions immoral-
ity will increase following on sterilization. Take,
for instance, the feeble-minded girl on the records
of a certain Massachusetts institution, who had

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THE OBJECTIONS MOST OFTEN URGED

been given her freedom eight times and each time
had come back to present the institution with an-
other baby, as subnormal as herself. Eventually
the authorities got tired of rearing small imbeciles
for this girl and decided to commit her perma-
nently until after her menopause. Now suppose
that, instead, she had been sterilized, and knew it.
She didn't really want a single one of those babies.
Which ought we to consider the more immoral —
bringing into the world eight children of defective
parentage, returning home for several months in
between and having promiscuous intercourse, or
staying at home all the time, working at some sim-
ple task, having promiscuous intercourse whenever
she wants to, but having no children as the result
of it?

It seems to me that the latter is immeasurably
preferable, even though the total amount of her
promiscuity should become greater.

One point that few objectors think of in this con-
nection is that the woman by herself cannot be
"promiscuous." The men who are her partners
must also be borne in mind : if they are the kind
who indulge in that sort of thing, then the mere
fact that one girl has been sent away to an institu-
tion is not going to discourage them. Whereas,
if that girl were sterilized she might make a good

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THE CASE FOR STERILIZATION

wife for some man who would be delighted that
she was sterile. Some persons go on to say that,
being at liberty, this girl would spread venereal
disease ; but I believe that if we were able to survey
a thousand such cases and tabulate their subsequent
behavior, we should find that actually so many of
them have married that this menace has been
materially limited.

But suppose we grant that with some persons
the knowledge that they were sterile 'would lead
them into immorality; we should have to remem-
ber that there is always something on the wrong
side of the ledger in every worth-while social
agency. If we could tabulate and describe the im-
morality that can be traced directly to the automo-
bile, we might be astonished. The automobile has
unquestionably led to a great increase in crime by
making it easier and safer; it has offered new op-
portunities to certain types of sexual immorality;
it has led many people to spend money that they
couldn't afford to spend. Isn't all this "increasing
immorality"? But does that mean that we ought
to scrap all the motor-cars? Of course not; they
have too much to their credit on the right side of
the ledger. With every novelty introduced into
life, we have to balance its good effects against its

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THE OBJECTIONS MOST OFTEN URGED

bad ones ; and in sterilization I believe the balance
to be on the side of the good.

"The Sterilized Will Be Exploited." Objectors
say that the low-grade feeble-minded girl will con-
tinually be taken advantage of if she is sterilized
and given her liberty. But they forget that the
low-grade feeble-minded are not to be "given their
liberty" ; because they cannot cope with the normal
world, they must be kept housed continuously.
For such, sterilization is hardly worth while be-
cause it is not called for. But it is called for in
the case of most of the feeble-minded living outside
of institutions — in private homes, on farms, and so
on — and in the situation these are in at present
there is (under existing conditions) exactly the
danger feared: they are taken advantage of, and
with disastrous results which would be avoided if
they were sterilized.

"Gland Treatments Will Serve Just as Well."
We ought not to sterilize, so I am often told, be-
cause if we wait a few years so much progress will
have been made in gland treatment that we can
remedy all our troubles by injections of hormones
and their derivatives. Many intelligent people
have brought this point forward ; but it represents

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THE CASE FOR STERILIZATION

a negative medical view. The fallacy gave con-
siderable trouble, I recall, in the "Fitter Family"
contests instituted by the American Eugenics Soci-
ety in order to stimulate interest in family and
heredity. Numerous families competed for the
honor of being adjudged the "best." First of all
there were rounded up a large staff of doctors,
dentists, psychologists, public health officials,
nurses, and so forth. Then we had each member
of the competing families examined as carefully
as possible. Well, in nearly every case the persons
whom we found we ought to educate were the doc-
tor and the dentist! What we were looking for,
of course, was high physical and mental qualities ;
but if a woman had had a breast amputated and
the scar showed that the surgeon had done a fine
operation, our examining physician was likely to
give her a perfect score. The same with the den-
tist, who rejoiced when he found a person with
an entire set of false teeth. He would examine the
plate and, if the work had been done beautifully
and skillfully, if it fitted the mouth perfectly, he
would put down 100 for the teeth score — whereas
he should have awarded a goose-egg. Fortunately
this medical attitude is changing.

It is only short-sighted medical opinion that
looks toward cures and treatments rather than

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THE OBJECTIONS MOST OFTEN URGED

toward prevention. The really fine body is the
one that does not require medical care. Our ideal
to-day is prevention, and those who advocate steri-
lization are looking toward prevention. To these
persons, the very thought of administering daily
or weekly hypodermic injections to keep the sub-
ject from insanity or feeble-mindedness is repel-
lent. If you know any diabetic person who from
childhood onward has had to have periodic injec-
tions of insulin, you realize what a task it gets to
be before long. To elderly persons, of course,
whose need for the treatment comes on in later
life, insulin injections are a godsend. But to bring
babies into the world condemned to the gland-
treatment regimen for some defect is unthinkable,
especially since it is quite possible to avoid giving
life to them at all. Once the baby arrives, give
him the necessary treatment, by all means ; but in
Heaven's name let's not bring him into the world
knowing that he is going to need it! The Rev.
George Reid Andrews expressed this ideal suc-
cinctly in a sermon: "We should insist that the
production of babies be at least as carefully
guarded as their preservation" If we begin think-
ing about production a little more, and think about
it in connection with the after-care that certain
types of children will inevitably need, we shall be

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THE CASE FOR STERILIZATION

approaching the time when every person interested
in race betterment will be satisfied. That time
cannot come too soon.

"Sterilization Is Class Legislation." The United
States Constitution forbids class legislation, and
we are told that what we are urging is class legis-
lation. So it is, in a sense; but not in the sense
that the Fathers of the Constitution had in mind.
They were not thinking of "class" in its biological
sense; they meant religious and political class —
the Methodists, the poor, farmers, Democrats.
But in every one of these classes we find degener-
ates, who may be said to constitute a class only in
an arbitrary sense. This is a class determined by
mental and emotional level. That sterilization
laws are not "class legislation" in the forbidden
sense was settled by the Supreme Court in Carrie
Buck's case. Had they been this, the case would
hardly have been settled as it was, and almost
unanimously.

Suppose, however, that sterilization laws are
"class legislation." What of it? We already have
plenty of "class legislation" of this kind. We vac-
cinate a "class" of children — those who have not
been vaccinated before. We legislate to move a
"class" — slum-dwellers — out of their bad environ-

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THE OBJECTIONS MOST OFTEN URGED

ment and into a good one, building decent homes
for them to live in. Many an approved social
activity to-day could be called "class legislation,"
and yet we wouldn't dream of abolishing it.

[213]

CHAPTER XIII

THE OBJECTIONS MOST OFTEN URGED — II

CHAPTER XIII

THE OBJECTIONS MOST OFTEN URGED — II

Some of the opponents of sterilization express
their fears that after birth control and sterilization,
or perhaps in connection with it, there will come
the lethal chamber, and that the outlook is a black
one for mentally deficient persons. In the place of
sterilization they suggest instead that defectives be
maintained in institutions until they have become
trained, and then be turned out and allowed to
marry and reproduce. At least one book has been
written expressing these fears.

Will sterilization laws lead straight to legis-
lation establishing the practice of "euthanasia"?
That idea has not been without its advocates
among estimable members of society. In any
case, I never heard or read a single statement from
any proponent of sterilization that suggested the
lethal chamber as the next social amenity; though
perhaps what the writer means is that, once a
law is put through empowering certain people to
make other people sterile, the way will open broad

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THE CASE FOR STERILIZATION

and easy to further laws empowering them to make
other people die.

It is somewhat difficult to take this objection
seriously in view of the agitation against the death
penalty and in view of compulsory insurance,
medical laws and the present day agitation against
war. A great many indications show that as social
consciousness increases, respect for human life
grows with it. Furthermore from any but the most
ultra conservative point of view it is distinctly
arguable whether sterilization could be called
tampering with human life and whether we owe
the coming of subnormal babies to any one but our-
selves. It emanates from intelligent people by the
thousand, none the less. "God sent these poor un-
fortunates, and it is our duty to take care of them."
Is this, one may ask, supposed to imply also allow-
ing them to grow up and bear other unfortunates
like themselves? Isn't our "duty" to them satisfac-
torily fulfilled when we pour out the public funds,
and dip down into our own pockets to swell chari-
table funds, in order to keep these subnormal peo-
ple alive and comfortable? Is there any failure to
"care for" them in the mere act of making sure
that they cannot reproduce? For this is all that
the sterilization advocates propose.

These objectors often go on to say that it is

THE OBJECTIONS MOST OFTEN URGED

"natural" for these subnormals to exist in human
society ; that it would be "unnatural" to try to re-
duce their numbers gradually. Such an argument
proves a sad ignorance of the ways of Nature, for
if there is one thing evident in the natural world
it is the tendency for those creatures that are too
feeble for self-support to die off. Go into the
woods, where civilization has not yet interfered
with Nature, and try to find some defectives. You
will find an albino animal here and there, and a
few that are struggling along with some other slight
defect that is bound eventually to defeat them in
the fight for existence ; but you will find that these
animals, born with traits that unfit them for sur-
vival, seldom live long enough to reproduce. Na-
ture, who seems cruel in this respect, is really kind.
But she is kind in her own "natural" way, not in
our artificial human way : she lets these defectives
die off, not go on living and producing other de-
fectives. If an imperfect bird or rabbit is born, it
dies. If an imperfect child is born, we hesitate at
anything so "unnatural" as preventing its reproduc-
tion. In Nature, the defect ends with its victim.
In civilization, the defect is allowed to multiply
itself a hundredfold even unto the third and fourth
generation. Yet some of us believe, with Justice
Holmes, that "three generations of imbeciles is

[219]

THE CASE FOR STERILIZATION

enough." And I may allow Charles Darwin to
say the final word on this question of naturalness.
"The war of Nature is not incessant, no fear is felt,
death is generally prompt, and the happy and the
healthy survive and multiply."

Since the "unnatural" objection is often raised
by persons with conservative ideas on the sub-
ject, I may here cite two comments that have
reached me from the opposite schools of thought.
I met a young friend who had seen something
which shocked him greatly. He told me about a
family of six children that he had recently run
across, every one of them blind. He protested,
"Such a thing should not be allowed to happen!"
And I agreed. Nor would it have happened if
there were a law permitting sterilization to any
who apply for it.

The next story representing the other side of
the question comes to me from a woman ac-
quaintance. To a friend one day she read aloud
a newspaper story from a New Jersey city that
shocked her profoundly. The friend, however,
was not shocked. She was a woman of the most
highly intelligent sort, daughter of one of our most
distinguished artists, but strongly bound by the
teachings by which she had been brought up. The
item reported that a New Jersey woman had just

[220]

THE OBJECTIONS MOST OFTEN URGED

borne her sixteenth child in sixteen years — and not
one of the earlier fifteen babies had lived to the
time of the next one's birth. My friend com-
mented: "How much better if that woman had
spaced her babies, had only four, say, and brought
them all up to useful maturity!" "Not at all/' was
her opponent's retort; "she has done her duty in
bringing sixteen little souls into the world, whether
they lived or not. Her duty is not the bearing of a
few who may grow up to be good citizens ; it is the
bearing of many — as many as possible — to become
immortal souls."

Here and on the previous page are two clear
illustrations of conflicting points of view by equally
conscientious and scrupulous persons. The advo-
cate of sterilization would say regarding the last
case that here not even contraception, probably,
would secure good social ends, if the heredity or
the environment represented by that mother was
such that apparently none of her babies was viable ;
that rather the case called for sterilization.

"Our Existing Laws Are Not Being Used!'
Sterilization, it is sometimes argued, would be im-
practicable even if we succeeded in legalizing it all
over the country, because many of the States that
have laws already do not enforce them — proving

[221]

THE CASE FOR STERILIZATION

that public sentiment in those localities is actually
opposed to the procedure. I have already dis-
cussed the reasons for the occasional lapses in ad-
ministering the law; they are not sentimental —
they are political. Many a superintendent of a
State institution would like to resort to the opera-
tion oftener than he dares to do under existing con-
ditions; if he descries in the middle distance a
political or religious bloc that is opposed to the
law, he is naturally likely to watch his job. And
this sort of thing will always go on, probably, more
or less, man being a political animal. My own
opinion is that it is bound to go on, anyway, wher-
ever the law is a compulsory one.

"Segregation Will Serve as Well!' Some of
those who consider sterilization uncalled for do so
because they feel that we should gain the desired
ends equally well by establishing segregation colo-
nies in which mental defectives could be kept all
their lives. It is not an unworthy suggestion, and
in an earlier day than ours has been practicable.
But it is out of the question by now. The initial
expense would be staggering, however justified in
the end. To make it at all possible, we should
have to try to get enough productive labor out of
the inmates to pay a part of their maintenance,

[222]

THE OBJECTIONS MOST OFTEN URGED

and this would bring a terrific howl from organ-
ized labor, the same kind of howl that rises when-
ever the State undertakes to sell prison-made
articles on the open market.

But the decisive reply to this objection is that
while segregation is excellent and we need more
of it, it does not meet the real danger. The real
danger lies, as we have seen, in the border-line
group, and there are too many of these to segre-
gate. If we could place about 10,000,000 in segre-
gation camps, the plan might be worth a trial.
But immediately comes another thought : Wouldn't
this vast army want to have their wives and hus-
bands living with them? Imagine erecting colo-
nies, separating families, and keeping such people
satisfied with their lot! The only alternative would
be to establish colonies, sterilize one of each cou-
ple, and let them live together without the constant
risk of unwanted babies.

But why, in that case, establish colonies at all?
From the viewpoint of a planned society, it would
be equally feasible and far more advantageous to
allow the border-liners to live in places where they
could do some useful labor, have perhaps one or
two children, and then be given the means of stop-
ping at that point. Society would thus gradually
dispose of them.

[223]

THE CASE FOR STERILIZATION

"Sterilization is Injustice'' Is it unjust to ster-
ilize, as some argue? I believe that I have shown
that there is no injustice in it. The state may
compel the individual to do a good many things
that make him feel unjustly treated, the principle
being that his rights are subordinate to those of the
body politic when the aim is the public welfare.
The drunken driver objects when he is arrested —
he "has a right to get drunk." The insane crimi-
nal objects to a jail sentence, because he "hasn't
done anything wrong." And many a mother ob-
jected (rightly, in my opinion) to having her boy
conscripted and sent to France. But the state
argues that all these measures are designed for its
safety.

Even so, the sterilization of a defective, espe-
cially one who has asked that it be done, is not an
injustice. The Supreme Court decision voiced the
answer to this objection very well in the opinion
written by Mr. Justice Holmes: "We have seen
more than once that the public welfare may call
upon the best citizens for their lives. It would be
strange if it could not call upon those who already
sap the strength of the state for these lesser sacri-
fices, often not felt to be such by those concerned,
in order to prevent our being swamped with in-
competence."

[224]

THE OBJECTIONS MOST OFTEN URGED

"We Need Morons for the Ugly Jobs'' Some
really thoughtful people have objected to steriliza-
tion on the ground that it will cut off from society a
large body of persons whom we need to do our dirty
work. They do not always put it so brutally as
that, but in effect that is what they mean. The best
answer that I know is that if we did not have the
people to do the ugly jobs, we would find some
way to abolish the jobs. Necessity is here the
mother of non-invention.

I can remember many dirty jobs that I had to
do, years ago, when I was a farmer. They were
the same jobs my ancestors had had to do, none of
whom — so far as I can ascertain by a careful fam-
ily study — were feeble-minded. The toilet facili-
ties, in my day as in theirs, were in the backyard,
and sometimes I had to clean the cesspool — a job
that I would cheerfully have deputed to somebody
else. I milked a string of cows by hand. All our
farm work was done with horses. In winter when
my wife and I drove to town the snow was driven
into our faces from the flying heels of the horse
hitched to our sleigh. We butchered our own
animals, and Mrs. Whitney often tried out the gut
lard. We had no electricity, no city gas.

To-day, what a contrast! We still live in the
country, but under very different conditions. Milk,

[225]

THE CASE FOR STERILIZATION

extracted by mechanical milkers, is delivered to
our door. We boast a septic tank, and our plumb-
ing is inside the house. We ride in an automobile
or a trolley car. We buy meat that has been butch-
ered in mechanized factories quite unlike the old-
fashioned slaughter-houses. Running water is
pumped from a deep well by an automatic pump.
Canned gas is delivered. In short, we have all the
comforts of the city.

Twenty years ago it would have seemed very
fine to me to have a moron around, to do all those
ugly jobs for me. But to-day they are done by
methods which no longer require the services of
that moron. They are no longer "dirty work" be-
cause people have bent their inventive intelligence
to their needs, perfecting devices that to a great
extent eliminate the unpleasant phases of certain
jobs. The more inventions we human beings
think up, the less we need the moron.

There is an ethical consideration here, too, which
appeals to me. When people say that we need
morons to do our dirty work, they seem to forget
that they are talking about human beings, that they
are deliberately degrading their fellow-men to the
category of the slave or the mule. In the South
they used to say that slaves were needed for the
menial labor. But hasn't that day passed? Let us

[226]

THE OBJECTIONS MOST OFTEN URGED

hope so. Work of any kind is becoming less and
less degrading. Time was when working in the
woods, for instance, was not particularly inspiring.
But to-day with modern methods of lumbering it
requires brains to do this work, and under these
conditions many intelligent people have learned
that there is no more healthful or exhilarating la-
bor to be found. The truth is that what dirty
work there is left in the world will become clean
work just as soon as intelligent people do it.

"Sterilization is Mutilation/' Then we hear it
said that the state has no right to "mutilate" the
body of any of its individuals. But it does have
that right. It has the right to compel vaccination,
which leaves a scar far more apparent and objec-
tionable than the scar left from either vasectomy
or salpingectomy. And if the individual has a
contagious disease, he may be isolated by the state's
orders. If he commits a crime, he may be put to
death by the state. If he commits a nuisance, he
may be incarcerated. If he goes about in a filthy
condition, he may be forced to cleanse himself.
If he has a job that involves serving food publicly,
he may be regularly examined by a physician to
make sure that he will not communicate disease to
innocent people. The fact is that a degenerate is

[227]

THE CASE FOR STERILIZATION

exactly as great a menace to society as any of these,
and far worse than some of them; and he should
not be allowed to produce offspring who may be
like himself.

"Religion Calls It Immoral." The objection is
raised by some that religion dictates against sterili-
zation on the ground that it is immoral. Now it
might be possible, if we were to hunt far enough
among the writings of the Church Fathers and the
Calvinistic theologians, to find some passage di-
rected against it — though it is doubtful whether
any of them could have had in mind the processes
that to-day we mean by sterilization. On the other
hand, if we were to search the Bible — which, after
all, is an acknowledged authority among all faiths
worth considering in this regard — what we should
find instead is hundreds of passages that urge the
upbuilding of the human stock. The Jews have
always held racial purity and excellence above
nearly everything else. Their taboos against mar-
riage with inferior peoples and with Gentiles were
equally strong. They are, indeed, an inspiration
to other races in this respect.

The Talmud, even more than the Bible, continu-
ally preaches race purity and family upbuilding.
"Let a man sell all he has and marry the daughter

[228]

THE OBJECTIONS MOST OFTEN URGED

of a learned man of the time. If he cannot find the
daughter of a learned man of the time, let him
marry the daughter of the head of a congregation.
If he cannot find the daughter of the head of a con-
gregation, let him marry the daughter of an al-
moner. But let him not marry the daughter of
the unlearned, because their wives are vermin and
of their daughters it is said 'cursed is he who lieth
with a beast/ "

It seems to me that the practice of citing ancient
and superseded authorities to prove our theories
ought to be dropped in this era of science. What
an enormous amount of tragedy this has caused!
Take the attitude of religion on the use of anes-
thesia in the middle of the nineteenth century.
That controversy was as bitter as is ours to-day
over contraception and sterilization. The clergy
long held out against anesthesia, citing authorities
who said that it is immoral not to let a person suf-
fer, particularly a woman in labor. In the third
chapter of Genesis, for instance, they found: "In
sorrow thou shalt bring forth children." Conclu-
sive : God intended that women should endure un-
mitigated agonies forever because Eve ate the
apple. Then along came some physician who
found, in the second chapter of Genesis, this effec-
tive come-back : "And the Lord God caused a deep

[229]

THE CASE FOR STERILIZATION

sleep to fall upon the man" — this being in prepara-
tion for the creation of Eve from one of Adam's
ribs. Equally conclusive: God Himself had re-
sorted to anesthesia ; it was therefore all right for
man to do it. All of which sounds either highly
ridiculous or distressingly blasphemous; yet it is
exactly what happened in the days of the dear
Queen. And to-day, very few of even the most
conservative religious folk wish to lift their voices
against the use of anesthetics. It is no longer
"moral" to make people suffer unnecessarily.

[230]

CHAPTER XIV

THE WRONG SIDE OF THE LEDGER

CHAPTER XIV

THE WRONG SIDE OF THE LEDGER

Back in the days when we drove those old
Model-T Fords, the magazines were full of adver-
tisements of gadgets guaranteed to save gas. I
remember buying a carburetor that was guaran-
teed to add a third to my gas mileage. I bought,
too, some hot-shot spark-plug arrangements that
were guaranteed to get at least six miles more out
of every gallon of gas. I have concluded since
then that neither of these things ever made any
difference. There were a myriad other contrap-
tions advertised, too, each of them guaranteed to
increase my gas mileage. So one day I added a
lot of these "guarantees" together, and behold, if I
had bought the things I could have run on no gas
at all!

We have heard recently that the annual crime
bill in America is from ten to sixteen billions of
dollars. And here we are worrying about a paltry
Treasury deficit of nine billion! We are told also
that, if every man in the United States were to

[233]

THE CASE FOR STERILIZATION

drink a glass of beer a day, the nation would be
inefficient to the extent of six billion dollars a
year. Noise, too, is said to cost us several millions
a year in loss of efficiency. Common colds cost
more millions. Toothaches, headaches, athlete's
foot, excess use of cosmetics, rheumatism, halitosis,
and sundry others add still more to our national
losses.

Now if you were to add all these things together
you would realize that in no time at all you have
accounted for about three times the national in-
come of fifty billions, and that if we could actually
make these savings there would be no need for any
of us to work. In fact, we could be well paid for
going to sleep and staying asleep, just as the old
Model-T Fords could be made to run on less than
no gas if you just bought all the gas-saving gadgets.

I realize that the burden of our subnormals is
perfectly tremendous. The bill probably does run
into the billions if we consider the cost of the
crime, the pauperism, the institutional care, and
the other burdens that spring from that source.
But I have no intention of adding any more figures
to the billions cited above. Rather I shall attack
the problem in what seems to me to be the logical
way.

Every time a degenerate is born, somebody has

[234]

THE WRONG SIDE OF THE LEDGER

to support him or her. It may be a private indi-
vidual who has to be made unhappy by the en-
trance of the newcomer into the world. It may be
a public institution. Moreover, some one must pay
when the subnormal does something unsportsman-
like— breaks the rules we have set up for the game
of living. On the whole, the subnormals are very
poor sports. When a burglar broke into our home
during my boyhood and stole all my parents' silver,
which had been given them as a wedding present,
he did more than remove some valuable knives,
forks, and spoons : he left a lot of heartache be-
hind— more than the silver was worth; and we
have no way of evaluating such unhappiness.
Every time the Community Chest of your city pays
for a ton of coal, every time the Charity Depart-
ment of your State pays for the food and care of an
insane person, you, too, pay out something.

And all the time that the money is going out,
our degenerates are demanding more, with no
prospect of return. Now, if you were the owner
of a stock farm and had a herd of cattle, you would
say that you had money invested in the cattle. They
represent, however, an investment that you are
trying to make pay you something. Of course, if
you are a so-called gentleman farmer the herd
may not be paying you any income. Yet the money

[235]

THE CASE FOR STERILIZATION

would still be an investment, because you could
sell them any time — you could realize on them.
Every time a calf is born, you add that value to
your inventory, and your inventory represents your
capital outlay.

Very well. Just what difference, from an eco-
nomic viewpoint, is there between your investment
in cattle, which cost you plenty to feed, and the
problem that society has in its degenerates? I have
never heard any one discuss our degenerate classes
as an investment, but what else is it? Every time
a new subnormal is born, we may say that we have
tied up a certain sum of money in that person.
Looking at it another way, we shall have to deposit
in the bank a sum of money large enough to yield
sufficient interest to support that subnormal for a
year.

If we consider only the feeble-minded who are
in institutions, it has been calculated again and
again that it costs at least a dollar a day to feed and
clothe one of them. It costs a great deal besides this
to take care of them, of course, since board and
clothing are not their only needs. But suppose that
we first consider the food-and-clothes cost — $365
a year per capita. How much money at 5% would
we have to deposit in order to produce $365?
$7>3°°- But, as I have said, that isn't all. How

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THE WRONG SIDE OF THE LEDGER

much does it cost to build and equip an establish-
ment that will house, say, 1,000 feeble-minded per-
sons adequately? Surely a million dollars, the
way it is done to-day. Add another $1,000 to each
person for that. And there, you might say, without
considering the cost of the overseers, the superin-
tendent, the nurses, the doctors and staff to look
after the inmates — there you have $8,300. So is
it not fair to say that every time a feeble-minded
child is born we at once invest $8,300 in it?

And now if we add all other costs to that figure
— cost to parents, payment for damage done, etc. —
we should reach a total of at least $10,000. Be-
sides these institutional figures we must take into
our reckoning the 80,000 feeble-minded persons in
subnormal schools. Adding the costs of these
brings our total up to $800,000,000. All this leaves
out of consideration those who are outside of insti-
tutions and schools — the insane, the epileptic, and
so forth. If our crime bill actually is ten billion
dollars, if it has to be paid every year, we have an
investment in criminal degenerates of two hundred
billions, the principal necessary to yield ten bil-
lions.

In New Haven in 1933 we spent over $3,000,000
on relief. In normal years our burden is only
about $500,000. But it is only fair to throw off

[237]

THE CASE FOR STERILIZATION

half of the larger sum on account of the unfortu-
nates whose plight is due to economic maladjust-
ment rather than to biological degeneracy.

In 1915, when Dr. Estabrook finished studying
the Jukes tribe, he made a calculation of official
expenses which the State of New York had been
called upon to meet on behalf of this family. Of
course, only the expenses that had been recorded
as official could be traced, and naturally not all of
these. But, doing the best that he could, Doctor
Estabrook recorded over $2,000,000. This did not
take into account any of the property damage
caused by various members of the family. It did
not take into account the time spent by various
charity workers who made hundreds of visits to
them, nor did it cover the misery that the family
caused. Nor, finally, did it cover the misery they
themselves suffered.

It might have cost the State of New York pos-
sibly a thousand dollars at the maximum to have
sterilized the first of that clan. Now, if we com-
pute the money spent by the State the first year, it
was doubtless trivial; so also for the second, and
the third, and up to the end of the second genera-
tion. But it began to grow, then, because the Jukes
grew in numbers. When the latest official check-up
of the tribe was made, there were over 600 then

[238]

THE WRONG SIDE OF THE LEDGER

living, and only seven of them were confined in
institutions.

Mental and other tests show us that the greater
part of the clan is subnormal, not sufficiently so
to be confined, but subnormal enough to be inca-
pable of doing anywhere near so much productive
labor as normal citizens, and so incapable and trou-
blesome as to be a perpetual care to the State.

Let us see if the figure of $10,000 which we said
had to be placed in the bank for every degenerate
born holds in this case where a family is outside of
an institution. Probably not over half of the pres-
ent 600 Jukes who are at liberty are of the lower
grades. I have met a number of them who were
well qualified to hoe their own row in the world,
but capable none the less of transmitting degen-
eracy. If 300 are of the potential caliber we are
considering, then we might say that the State has
invested in them 300 times $10,000, or $3,000,000.
Five percent interest on this amount would be
$150,000 a year, which is what they should be cost-
ing the State; as a mattter of fact, the average over
the past years, taken in proportion to their num-
bers, somewhat exceeds this figure. I think, there-
fore, that whether the subnormal individual is in
an institution or out of it, we are safe in assuming
that we have $10,000 tied up in each. If he is out-

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THE CASE FOR STERILIZATION

side, the State has court costs, police costs, and
chanty costs ; if he is inside, the State has the cost
of food and maintenance, plus the investment in
buildings and equipment. The subnormal are ex-
pensive luxuries, wherever they are.

In fact, such people are expensive more or less
in proportion as their intelligence falls below the
level of ordinary usefulness. They are below this
level if they suffer from a degree of incomplete
mental or emotional development, rendering them
incapable of independent social adaptation, and
necessitating external care, supervision, and con-
trol.

The sums spent by the several States on relief
during the depression do not, of course, accurately
reflect the cost of defectives.

Let us therefore go back to 1915 to get statistics
less distorted. In that year the States of the Union
spent a total slightly exceeding $75,000,000 for the
institutionalized defectives. This is the interest on
a billion and a half. They are spending more to-
day.

When we include criminal classes we find a very
different story. New York State alone appro-
priated for the fiscal year ending June 30, 1928,
$32,558,000 for the care of the feeble-minded, in-
sane, criminalistic, blind, deaf, paupers, and other

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THE WRONG SIDE OF THE LEDGER

institutionalized and socially aided classes. This
was exclusive of private charity, which was prob-
ably several times that amount. This represents
an investment in these classes of $651,160,000.

In New York State one person out of every 25
during a generation becomes an inmate of an
asylum or a residence for mental defectives. One
family in seven is represented. Then, too, it must
be remembered that there are several times as
many insane persons outside of institutions, who
never are admitted owing to the desire of the
family to maintain them at home. All this signi-
fies that the population of that great State is not
so sound mentally as it should be.

Dr. H. M. Pollack, who for many years was the
Statistician for the Mental Hygiene Society, made
an interesting estimate. Considering the 300,000
persons in institutions for mental disease, he deter-
mined to discover as nearly as possible what was
lost to these individuals in the way of earning ca-
pacity. After a careful study he concluded that
the average amount these people might have
earned during the rest of their lives, had they not
been deprived of their liberty, was $6,000 each.
Thus the 80,000 committed each year meant an
economic loss (above what we have already fig-
ured) of $480,000,000. This, taken with the an-

THE CASE FOR STERILIZATION

nual amount spent on the maintenance of the
300,000 ($150,000,000), represents a staggering
total.

Look at it in whatever way you please, you come
to the conclusion that from a financial point of
view degeneracy costs a great deal of money. But
to me, even that does not represent so enormous an
expenditure as does the misery to the people them-
selves which degeneracy entails.

Here we have considered only mental disease
and mental deficiency. What about the inherited
deafness, epilepsy, blindness, chorea, and other
maladies? Some are more serious than those we
have considered, but they are not so prevalent, and
we can ignore them.

Civilization is becoming more and more compli-
cated. Sounder brains are constantly being de-
manded to cope with modern conditions. That
quality which is best described as adaptability, one
of the most important human character require-
ments, is seriously lacking when so many people in
a State become insane. Yet it is just that quality
which is needed to render one adjustable and thus
secure in the face of our rapidly changing civiliza-
tion. It is becoming too rare.

Figures speak louder than words to some people,
though to some of us they prove boring. Enough

[242]

THE WRONG SIDE OF THE LEDGER

has been said already to show that our degenerates
now constitute an appalling investment, and there
is no doubt whatever that the investment is grow-
ing.

Frightful though this financial situation is, I be-
lieve that it is not so grave as other aspects of the
problem. What does it mean for the more intelli-
gent of us that, for instance, all appeals to the
public have to be written down to a low level, have
to be cast so as to reach the 1 3-year-old mind?
Agencies such as the newspapers and the moving
pictures have to earn money to be able to stay in
business. To earn money they must make their
films or edit their papers in such a way that these
will sell. And to make them sell they have to cal-
culate the average intelligence of their market.

The most successful producers know that the
average movie fan or newspaper reader is about
13 years old. To make sure that their pictures and
newspapers can be understood, they could almost
select a group of seventh-grade pupils and try out
their productions on them. If these proved to be
over the heads of such children, they would be
over the heads of half the population!

Of course, certain moving pictures are made
with the upper half in mind — pictures that appeal
to the reason and the higher emotions, pictures

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THE CASE FOR STERILIZATION

not so cheap and tawdry. Sometimes these make
money. One thing, however, seems never to occur
to the producers: if this were the only kind pro-
duced, then the lower half would go to see these
instead; whereas the upper half refuses to go to
see most of the junk.

Then, too, there are "class" newspapers — the
tabloids, for instance, which obviously are written
for the lower half. A tabloid editor knows that
this group can read pictures if they can't read
print; so he concentrates on the pictures and makes
the text so simple that any child who has just
learned to read can understand it easily. More-
over, the tabloid editor bases his appeal chiefly on
sex and the emotions, which in the scale of evolu-
tion are of course much older than reasoning
ability.

Civilization has to keep continually in mind the
lowest quarter and the lower half. These we shall
always have with us. But let us hope that the
"lowest quarter" in the future will not be on so
low a level of intelligence as it is to-day. We have
much more than a mere financial problem. We
have the shame of this degradation of everything
decent in life, pulled downward to meet the under-
standing of the subnormal. And finally we carry
the burden of the unhappiness caused by the

[244]

THE WRONG SIDE OF THE LEDGER

childish conduct of the unintelligent and by the
depredations of the ill-trained and emotionally un-
balanced. The cost of crime is higher than any
official figures reveal. Heartaches are not meas-
urable in dollars.

[245]

CHAPTER XV

VOLUNTARY OR COMPULSORY?

CHAPTER XV

VOLUNTARY OR COMPULSORY?

There is, in my opinion, only one kind of sterili-
zation worth considering, and that is voluntary
sterilization. I know the arguments for compul-
sory laws, but I know also the practical objections
to these. Theoretically it would be well worth
while if we could appoint a tribunal which would
pass on the sterilization of several million persons
and thus in one gesture purge the race of a large
amount of degeneracy. Then we should merely
have to repeat the process at intervals when new
crops of degeneracy appeared. All this sounds
well, but in our democracy it is impossible of at-
tainment. Where sterilization has been made com-
pulsory it has not been so successful as where it has
been permissive. Nor would it be, anywhere else.

This operation must be identified in the public
mind as a eugenic one, a health measure and a
means of alleviating suffering. It has already and
wisely been taken out of the class of punitive meas-
ures. Allowing sterilization to become a stigma

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THE CASE FOR STERILIZATION

of criminality would be a serious handicap to its
acceptance. Having one's tonsils removed does
not stigmatize one, nor having one's appendix re-
moved. Even serious operations in some families,
generation after generation, carry no public
stigma. Yet any such operation is surely an indi-
cation that the person is in some way inferior, our
ideal being such rugged health that no operations
are necessary. But sterilization is both more be-
nevolent and less serious than many another that we
undergo as a matter of course. There are, too, so
many needing sterilization that no stigma need be-
come attached. In fact, we ought to respect any-
body who has been voluntarily sterilized when he
learned of his defects, as a person who is consider-
ate of his fellow-men.

It is strange that people seldom consider the
value to a race of eliminations from it. In biology,
for instance, those who fail to survive sometimes
contribute by their very deaths as much to the wel-
fare of the rest as those who do survive. That is
because we cannot remove one minus element with-
out adding to the plus side. And when we subtract
a plus element we add to the minus. But no sac-
rifice is asked for in this case; we merely supply
what is desired.

There is in sterilization a parallel to finger-

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VOLUNTARY OR COMPULSORY?

printing. I have made a goodly number of finger-
prints, both to show people how it is done and to
use the prints as marks of identification. Finger-
printing, every one who has thought about it
agrees, should be a universal mark of identifica-
tion. And why isn't it to-day in America? Chiefly
because a stigma has wrongly become attached to
it, and respectable folk shrink from being finger-
printed. They have heard that a prisoner is finger-
printed at once, and the impressions are kept on
record. They know that the authorities keep files
for identification of the criminal element, along
with pictures. The Rogues' Gallery has been so
well publicized that our people have come to think
of careful identification only as a system of catch-
ing rogues.

It is thus no exaggeration, probably, to say that
the majority of people who are not already en-
lightened shrink from even the thought of being
finger-printed. What they are afraid of is not the
putting of their marks on record ; they dislike the
idea of submitting to what they have always asso-
ciated with criminals. This may not, of course,
represent a high degree of common sense, but it is
perhaps only natural.

In just the same way, if sterilization is made
compulsory, is performed on inmates of public in-

THE CASE FOR STERILIZATION

stitutions without their consent, it too will gradu-
ally create in the minds of most people a feeling
that it is somehow a disgrace. Already, and very
wrongly, they have come to consider it disgraceful
to have been an inmate of any public institution;
hence the many private, secret institutions. This
is just as ridiculous as though we were to consider
everybody disgraced who had been to a hospital.
There is no essential difference: in one case the
patient is sick in one part of his body, in the other
he is sick in a different part — the brain, or possibly
the ductless glands.

Let us never allow sterilization, this agent of
racial betterment, to become a stigma. It isn't
to-day; let us see that it does not become so to-
morrow. If, however, we make it a matter of com-
pulsion, there is no doubt that it will take on this
unwelcome connotation. This would be almost a
disaster, since, as we have seen, the people who
need to be sterilized are not chiefly those in insti-
tutions, but those at large in the population. The
voluntary kind, I say again, is the only kind worth
working for.

In this conviction, I am happy to note, I am sus-
tained by the decision of the Department Com-
mittee on Sterilisation of the English Board of
Health. This body of learned men say in their

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VOLUNTARY OR COMPULSORY?

report, published by the British Government in
1934: "We are convinced that the harm done by
compulsion would far outweigh any possible ad-
vantage resulting from it." This Commission
comes to the conclusion that there are adequate
grounds for sanctioning voluntary sterilization.

Though there may be no certain prog-
nosis in any particular case, we know
enough to be sure that inheritance plays
an important part in the causation of
mental defects and disorders. We know
also that mentally defective and mentally
disordered parents are, as a class, unable
to discharge their social and economic
liabilities or create an environment favor-
able to the upbringing of children, and
there is reason to believe that sterilisa-
tion would in some cases be welcomed by
the patients themselves. This knowledge
is in our view sufficient, and more than
sufficient, to justify allowing and even en-
couraging mentally defective and men-
tally disordered patients to adopt the only
certain method of preventing procrea-
tion. In this view, as in all our recom-
mendations, we are unanimous, and we
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THE CASE FOR STERILIZATION

record it with a full sense of our responsi-
bility. We believe that few who ap-
proached the question with an open mind
and listened week by week to the evidence
we have heard could have failed to be
struck by the overwhelming preponder-
ance of evidence in favor of some measure
of sterilisation.

Another thought is relevant here. Of all the
sterilizations thus far done in America, only a very
few have been performed at the instance of the
State. It has been fully demonstrated that there
is very little need for this, so why all the commo-
tion, considering that there are so few who could
object to the permissive sort and so many who
might object to the compulsory kind?

We are told that in Germany sterilization is
compulsory. But let Germany worry about that.
I believe that if that country were to make her
legislation permissive, she would in the long run
achieve as great results as she will under the pres-
ent system. German surgeons, we are assured, are
going to sterilize 400,000 persons during the next
few years. This will help Germany materially to
reduce her charity burden in the next generation.
But I feel that had she adopted the voluntary

[254]

VOLUNTARY OR COMPULSORY?

method and trusted to persuasion and thorough
education by intelligent medical counselors, she
would progress just as far by inducing her defec-
tives and their kin to grant permission, for the
future of the Vaterland and the well-being of their
families. If patriotism to-day runs higher in Ger-
many than in many other countries, it is because
it is kept stirred up and alive, with biological pa-
triotism as the incentive. And though biological
patriotism is a comparatively recent phenomenon
among human beings, selfishness is very old, and
selfishness can be relied on to do some things that
patriotism cannot; so can altruism. Selfishness
plus sterilization can reduce the degenerates, as it
has already started to do. Altruism plus a little
self-interest and pride can increase our best peo-
ple, as it has already begun doing.

[255]

CHAPTER XVI

PAYING THE PIPER

CHAPTER XVI

PAYING THE PIPER

All the Protestant churches in the United States
except the Lutheran have issued proclamations or
made statements supporting the practice of birth-
control; so have the Jews. The Lutherans have
not condemned it, but they have decided not to
voice an opinion as a church. The first pronounce-
ment came from the Unitarians, and I feel just a
little pride in having had something to do with
that. Once, in Boston, I spoke before a large
group of the Unitarian ministers of New England,
suggesting that they pass a certain resolution that
I left with them. Shortly afterward they did so,
altering my wording somewhat but essentially ex-
pressing the same thought.

The Federal Council of Churches set forth their
feeling on the matter as follows :

The uncompromising position taken
against preventing conception, under any
and all circumstances, except by absti-

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THE CASE FOR STERILIZATION

nence, is manifestly an extreme one, and
even dangerous. Certainly there are cir-
cumstances of health and disease, recog-
nized everywhere by physicians, which,
when abstinence is not to be relied upon,
make the use of contraceptives wise. The
arguments from nature and inferences
from authoritarian doctrinal positions,
upon which the encyclical so largely re-
lies, are labored and inconclusive. . . .
Catholics themselves in increasing num-
bers will not submit themselves in
"filial and humble obedience toward the
Church" in all these matters. Half of the
patients in the Los Angeles birth-control
clinics are Catholics, and the people of no
country in the world regulate birth so
effectively as the French.

The Lutherans in general are in favor of con-
traception, individually if not as a church. And
we may say that those people who have no religious
affiliation are just as whole-heartedly in favor of
the widespread practice of birth-control as are
those connected with churches.

When we come to the question of sterilization, it
has been my observation that most people consider

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PAYING THE PIPER

it another means of birth-control, differing chiefly
in being final. I think we are safe in saying that
the same great groups which have endorsed birth-
control will even more heartily endorse steriliza-
tion if they are called upon to do so. There is,
therefore, potentially, a ready-made alignment of
interests in favor of the project in America.

On the one hand, we have all those who are in-
terested in racial improvement, who want to see
the problem of degeneracy decreased for the sake
of reducing the misery of the degenerates them-
selves. They are thinking also of the possible sav-
ings, the removal of burdens from the more worthy
people, and the heightened prosperity of the na-
tion. Many of them think, too, that those who will
have to bear the burden of future incompetence
are diminishing in numbers owing to their failure
to fulfill family-survival quotas; thus they realize
that the burden will be all the harder when those
who need help may have doubled.

On the other hand, we are opposed by some of
the clergy, who insist that birth-control be refused
to all, that sterilization be avoided.

There was a time when we could sit back com-
placently and try to convince ourselves that actually
there was nothing to worry over. It required a
depression to bring us to a realization that some-

[261]

THE CASE FOR STERILIZATION

thing was radically wrong. Even before the de-
pression actually set in students were warning us
of what was impending, but we were too busy
making money to take them very seriously. Only
now have we become fully aware.

The most happy people to-day seem to be those
who have convinced themselves that the old times
are no more, and who have decided to consider
that they must build again, but build more rapidly
with the accumulated experience of their past life-
times to help them. Those who sit, idly waiting
for some guardian angel to come and drop manna
into their laps are those who are most miserable
to-day. The new deal has been proclaimed be-
cause these are new times.

Then why should not the people of this new day
take stock and plan against a repetition of the
evils of the old days? We should. If we did this,
one of the first investigations we might make could
profitably be to scrutinize all of the forces which
are working for racial betterment, and those which
are opposed to it. We might consider charity for
example.

Most cities have their community chests from
which funds are distributed to those who need
them, regardless of race, creed or color. The funds
are not, however, distributed to members of sepa-

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PAYING THE PIPER

rate religious faith in accordance with their pro-
portionate part in the population. All over the
country, wherever I have studied, I have found
this same situation to exist. It is what you would
find if you were to make a similar inquiry.

Hence I, in view of years devoted to the study
of this vital problem, offer this suggestion, which I
believe is the one and only way to bring about a
reasonable adjustment. Establish separate Com-
munity Chests. One chest will be supported by
those who are interested in race-betterment, regard-
less of sect. Out of the income from that chest will
go expenditures carrying with them some perma-
nent alleviation. Out of the other, raised from
among those who prefer the older and more con-
servative methods, will go the funds to take care of
their incompetents. This will throw the entire
burden imposed by the increase of population ex-
actly where it belongs. Just as soon as people de-
cide that while they are willing to pay for a
reasonable thing they are unwilling to be mulcted
because of a policy with which they have no sym-
pathy— as soon as this happens, there will come a
rebellion. We had exactly such a situation in the
early days of our Republic when Britain tried to
collect taxes from colonies who had no share in
fixing them. "Taxation without representation is

[263]

THE CASE FOR STERILIZATION

tyranny!" was the cry that rang up and down the
Atlantic coast. To-day our donors of charity face
an analogous situation : they are seeing their money
used to perpetuate a condition that they disap-
prove.

Perhaps this argument may seem to some a far
cry from sterilization. But it is very intimately re-
lated. We have such good and reliable informa-
tion as to the increase of sub-normality, of the
reasons for its increase, of the ways and means
to reduce it both for the benefit of society and the
alleviation of the suffering and unhappiness of
the sub-normals themselves, that we can to-day
point our finger at this influence and say with as-
surance, "This is helping to build civilization."
We can point our finger at another influence or
social agency and say, "This is tending to lower the
general level of social values." We can prophesy
in some cases whether these levels are being per-
manently lowered or whether they are only tem-
porarily lowered.

We know that, given a sound citizenry, a great
change in our economic system can be serious, but
only temporary, but we know too that a great
change in the quality of the general heredity of
the people cannot be replaced, ever, from the same
people. Environment plus a splendid citizenry,

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PAYING THE PIPER

becomes more or less what the citizens make it,
but that same environment plus a group of sub-
normals becomes a very different appearing envi-
ronment when they have impressed it with the
natural propensities. This is seen over and over
again in our cities and in the rural districts. Some
of the finest old residential sections of New York
City and its boroughs are now slums, where yester-
day they were populated by the type of families
which furnish wholesome character to our na-
tional constitution. And those very sections are
as we see them today, because of the kind of people
who have moved in when the others moved out.

There is nothing about the argument for sepa-
rate community chests which is not apropos to
sterilization. We are talking about a race build-
ing measure, and we cannot accomplish this for the
whole population while a minority objects. So
we simply ask that minority to look after its own
people. Nothing could be fairer than that.

Some will say that if we do establish separate
chests, we shall have to look after the offspring of
those who oppose sterilization anyway. They say
that we shall have to support the miserable from
the public pocketbook, just as we are now support-
ing all kinds of people through the governmental
enterprises in the United States and through the

[265]

THE CASE FOR STERILIZATION

dole in England. But people who say this forget
that public opinion has been somewhat educated
by the depression, and will be further educated in
days to come. It will be a difficult matter to
awaken much enthusiasm in a public which knows
remedies and resolves to put them in practice even
though a minority objects.

But I imagine that we need not worry over the
situation. As a concrete example, persons who live
in neighboring apartments or houses are likely to
reach a certain stage of intimacy, and presently to
talk over family problems with each other. When
one group has neighbors who follow a more sen-
sible practice as regards the number of children
they produce, can we expect that group not to find
out about it and try to emulate the others? Any
number of thoughtful people are now speculat-
ing on the wisdom of the opposition to birth-
control and sterilization, and we may perhaps see
another "Reformation" in our own time, and with
it the realized dreams of the many liberals whom
we all know and greatly respect.

Let me close this chapter with a parable that
bears on this theme.

Two farmers lived on adjoining farms. Both
were potato-growers, and they had always been
good friends. One day they met on the road.

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PAYING THE PIPER

"Bill," Sam called out, "why don't you 'n' me do
a little cooperatin'?"

"Why not? What's on yer mind?" Bill re-
turned.

"Well, I been a-thinkin'. Here you raise pota-
toes and / raise potatoes. Now why don't we go
to work and do our farmin' together, like we hear
about other folks doin' in the magazines?"

"Good idea, Sam. How be we a-goin' to do it?"

"Easy, my boy. We'll pool our seed from last
year, and we'll plow and cultivate, and then this
fall we'll dig our potatoes and sell 'em together.
What do ye say?"

"O.K. Let's start as soon as plowin' time comes."

The two met again to talk over details. Pres-
ently spring came, and they joined forces and be-
gan plowing the two farms. They found it much
easier to treat the two as one — to plow straight
across instead of each plowing his own small field
and having to turn his horses around often, as be-
fore ; and they liked the new plan.

After plowing and harrowing came planting.
One morning the men brought the potato-planters
out from the sheds. Bill drifted over to see how
Sam's seed looked. There it lay in big piles.

"Jumpin' Jehosaphat!" exclaimed Bill. "You

[267]

THE CASE FOR STERILIZATION

ain't a-goin' to plant that gnarly, scabby, wiz-
ened-up trash, be ye?"

"Why not?" said his partner, looking up. "Why
wouldn't I?"

"And you knowin' enough to propose coopera-
tion in the first place? Surely you know enough
not to plant that kind of seed!"

"Well, I been a-plantin' of it every year, just
like my father V my grandfather did, and I'm
goin' to keep on. Fact is, I kin remember hearin'
my granddaddy say that it was always best to sell
the best potatoes and plant the rest. He done it
and what was good enough fer my granddaddy is
good enough fer me!"

"But what about me?" Bill protested. "Here I
been selectin' and selectin', tryin' to get my pota-
toes bigger 'n' finer V no scab on 'em. Soaked
'em every year fer scab, an' it's no wonder my
spuds have shelled out so fine every fall. And
what's more, everything I kin learn from them
fellers over at th' Experiment Station about
growin' 'em better, I'm going to learn. An7 I'm
a-goin' to use it too."

"Aw, come on, Bill," coaxed Sam. "Go ahead
and let's plant yours and mine all together. What's
the harm? I tell ye, what them old-timers said was
right. I'm goin' by them."

[268]

PAYING THE PIPER

Well, the preliminary work had all been done,
and anyway spring is the time of hope, so Bill felt
that for this one time he had better be a sport and
go along with Sam. They proceeded to pool their
seed, and they went to work. Summer passed.
Here and there were fine stalwart potatoes. But
by the time the crop was dug, some of the scab
from Sam's had infected Bill's, and in addition the
crop as a whole was much less than twice as large
as Bill by himself had had during previous years.

The time came to market the potatoes. Said
Bill : "Now looka here, Sam, let's select our seed
for next year, first thing we do. We've had a bad
enough lesson this season to know that a feller
can't grow good potatoes unless he has good seed."

"Save the seed?" exclaimed Sam in disgust. "I
guess not. We'll sell the best, and use for seed the
little poor ones that we can't sell."

Then (because this is a modern parable) Bill
replied: "Oh, yeah? Well, you go ahead and run
your farm, and keep plantin' your scabby, runty
seed. I'm a-goin' to keep the best fer seed. I'll run
my farm — you run yours — and some day maybe
you'll find out what plantin' that poor seed is costin'
you!"

[269]

CHAPTER XVII

A PLANNED SOCIETY

CHAPTER XVII

A PLANNED SOCIETY

To-day's discussion of our need for "a planned
Society" usually emphasizes aspects of our eco-
nomic structure. As yet, current talk has not
touched on a far more important need of contem-
porary life, the foundation on which any new eco-
nomic structure must be built, if it is to stay firm.
I mean a eugenic program.

There is no denying the fact that if we take ac-
count of the quality of a population as well as of
its numbers, we strike at the root of the problem,
for these two go hand in hand. Back of this ques-
tion, again, stands that of ambition, of goal.
Where are we heading? If we want to get some-
where, we first ask ourselves where we are going
and then take the most direct route. Where do
we want to go? We have over us no dictator mo-
tivated by self-glorification; we are not being
coerced into breeding a great army which he may
use to acquire new territory. We do not need
millions of men for national defense, since there is

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THE CASE FOR STERILIZATION

little likelihood of our being attacked by another
nation. Perhaps we should do well to adopt as our
ideal the desire to become a model nation, to live
contentedly within our own boundaries, to forgo
any plans of aggression, to produce as much as pos-
sible for the support of our own people, to be self-
sufficing and yet have enough surplus to help other
peoples when they need it.

A large proportion of our population is of in-
nately fine stock. We still have seed-stock from
which we might erect a nation such as the world
has never seen, a nation such as has only been
dreamed of. What else is there for us to do than
just that — become an object lesson? But what
kind of object lesson shall we become?

We need financial security. We are going to
achieve it, with effort. It has been argued, I think
convincingly, that we can get along very well in-
deed with a smaller population. But it must be
made more and more a quality population. Per-
haps we shall get that too. But if ever we are go-
ing to, our first and greatest necessity is the wide
and immediate dissemination of birth-control in-
formation. Every one must do what he can in the
direction of that legislative reform. We must
make available to every couple at the time of mar-
riage such information as will enable them to have

[274]

A PLANNED SOCIETY

as many or as few children as they want, and to
space the children properly. Progressive up-
ward evolution will inevitably set in. As I have
said earlier, what if the minus social elements do
have two children to satisfy their parental instinct?
At that they will diminish at the rate of 50% each
generation.

Give them the necessary information and in-
struction and let them decide for themselves
whether to have few children or many. If we sup-
pose their incomes to be reasonably stable, and if
each year they must make their choice between a
commodity and a baby, which do you think they
will choose? Here is a nice shiny automobile; and
here is a baby. Which will they take? Here is a
television apparatus, the newest and best on the
market. Will you choose that, Mr. Moron, or
would you like another baby? There, Mrs. Moron,
are the moving pictures, the public golf-course,
there are nine months of freedom w. nine months
of staying home — which will you choose? Mr.
Moron, here you see a squalling baby who will get
you up nights, and here you see nice long evenings
in the poolroom — which will you choose? A
Sears-Roebuck catalogue offers a thousand choices
between a baby and something else that looks
pretty tempting. Which will the morons choose?

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THE CASE FOR STERILIZATION

If you think they will choose more than one or two
babies, then you don't know morons.

The first step in building a civilization, there-
fore, is to place everybody on the same footing as
that on which our intelligent classes find them-
selves to-day. This done, sterilization will come to
the assistance of those who are too stupid to com-
prehend or to carry out the simple methods of con-
traception; to help those who are intelligent but
resolved, because they know they bear dysgenic
germ-plasm, that they will have no children at
all; and finally the relatives and guardians of de-
generates who want to protect themselves, their
family, and the race against the trouble to which
the pregnancy of a degenerate in their family
might give rise. In the program for a controlled
and planned society, sterilization^ will take the
place of contraception for a host of persons. It
will make contraception unnecessary in many cases
and will liberate the mind of the person desiring
an effective and permanent means of birth-control.

A planned society must imply the regulation of
births. But its birth-control program must be
threefold : birth-liberation for those best endowed
by Nature; birth-maintenance for the great aver-
age; birth-reduction for the lowest social elements.
Just one thing is essential: to make contraception

[276]

A PLANNED SOCIETY

and sterilization available. Superiority will of it-
self be the deciding factor. Superior people will
show their superiority in the test which is to come.
That test is the survival of the fittest, but the
question of who the fittest are will come to have a
new meaning. No longer will we make the mis-
take of translating fitness as brute strength; we
shall understand it to comprehend all that we hold
dearest in life — beauty, love, idealism, good citi-
zenship, honor, health, and the happiness that
springs from being able to create our families by
choice rather than by chance.

If I did not know that already within our ranks
we are witnessing a demonstration that this con-
dition can actually come about, I should not feel
so hopeful. But all our population figures show
that whereas the birth-rate dropped first in the
upper classes (considering class on the basis of in-
telligence) the ability to control this has slowly
crept downward until to-day it is almost possible
for the border-line group to control their births.
To-morrow it will be possible for them. And that
to-morrow can be brought closer by the efforts of
all intelligent people. "Ye shall know the truth
and the truth shall make you free."

[277]

CHAPTER XVIII

HOLDING THE BEAR BY THE TAIL

CHAPTER XVIII

HOLDING THE BEAR BY THE TAIL

Once upon a time there was a kind gentleman
who bought a bear-cub.

Now a bear-cub is about the most lovable little
creature ever invented by Nature. Anybody
would fall for one. Indeed, "Teddy Bears" owed
their popularity to this very susceptibility in chil-
dren and grown-ups alike. So we must not blame
the kind gentleman for yielding to his impulse.
Edward was the cutest of bear-cubs — so helpless,
so utterly dependent on its master for its every
need, so gentle and appealing. Never did Edward
scratch the kind gentleman, but lapped his hand
and followed him everywhere he went.

Edward lived on the fat of the land. Edward
grew. But for many months its owner, because
he was so close to his pet, did not notice the growth ;
though now and again he did wonder why Edward
was eating so much more food every week. Then
one day he awoke to the realization that his darling
little cub was losing some of its cuteness. That
night he didn't sleep very well, and he got up on
the wrong side of the bed. At breakfast he said

THE CASE FOR STERILIZATION

to his wife that maybe he had undertaken some-
thing that wasn't so laudable. However, he went
off to business, and came home feeling better and
having forgotten all about Edward in the mean-
time.

Day after day he continued Edward's feedings
— a little more every week. He brought his friends
over to see his pet, to admire Edward's proud
beauty. But pretty soon he found he had to stop
referring to "our cub" — Edward could certainly
not be called anything but a full-grown bear by
this time. Also it occurred to him after a while
that his pet didn't seem very grateful for every-
thing he was doing for it — acted, indeed, anything
but appreciative. Sometimes, when he set the dish
of food down, Edward would actually growl at his
kind master.

And then one day he took his bear out for a
stroll, leading it on a chain as usual. But as the
two were passing along the village street the bear
suddenly began to growl fiercely; then struck at
the kind gentleman with a tremendously powerful
paw. This seemed almost to hint ingratitude, and
the gentleman was much shocked. He dared not
drop the chain lest Edward should run loose
through the neighborhood and scare the people
to death. So he promptly did what he had been

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HOLDING THE BEAR BY THE TAIL

told was the only thing to do — he caught hold of
Edward's tail. The bear raced ahead, dragging
its master by its tail; then stopped and tried to
reach back. But its master only pulled a little
harder, sidewise. All that the bear could do was
to look around threateningly. All that its master
could do was to hang on. He hung, and he hung,
and finally, when he was completely exhausted, he
yelled for help. So a neighbor came out with a gun
and shot Edward. And that's the end of the story.

Some generations ago, we — the kindly people of
America — adopted a cute little harmless bear-cub,
in the form of our mentally handicapped citizens.
We fed them, clothed them, housed them, allowed
them to increase in size by continual augmentation
from immigrants of their own caliber. At first
we enjoyed helping these unfortunates. Those of
us who could afford it took no end of pleasure in
the consciousness that our charges were being gen-
erously provided with creature comforts.

But this bear grew, too, and once in a while we
found ourselves a little worried as to whether we
had done just the right thing. But we got over
that feeling, chiefly because we had argued our-
selves into believing that what we were doing was
the only thing we could do.

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THE CASE FOR STERILIZATION

And then the time came when our bear — our
subnormals and degenerates, our imbeciles and
morons — actually attacked us. There was just one
chance of salvation : we reached for the bear's tail.
And we have been hanging on to that tail ever
since. We daren't let go, because we know that if
we do, our bear will turn on us and tear us to bits.

Indeed, this is exactly the problem that now con-
fronts the better classes not only in our own coun-
try but in many another as well. They have a bear
by the tail, the bear that they have fondly tended.
They forgot that a bear grows up to be a treacher-
ous beast. They saw it first when it was appealing
and harmless, except for its potentialities. And
how are they now holding onto its tail? By charity,
which they no longer give cheerfully but have
come to look on chiefly as a means of self-protec-
tion.

Now charity, in its Pauline sense — love and
compassion — is essential to human nobility, and the
expression of it in kindly action brings strength
and happiness, "blessing him that gives and him
that takes." But organized charity should be di-
rected toward making itself gradually less and less
needed. It should end with one generation, if pos-
sible with one almsgiving. This is, of course, an
unattainable ideal. The ideal benefaction is a

[284]

HOLDING THE BEAR BY THE TAIL

charity to lessen charity — I mean ideal in the sense
of ultimate kindness, kindness to the recipient.
The true Good Samaritan not only binds up the
wounds of the stranger assaulted on the road; he
uses his intelligence to see to it that there won't be
any more attacks made along that road.

Have you ever thought what might happen if we
were to stop dispensing all this soothing-syrup?
The Community Chest is one of the things that
have carried America through the depression. We
have nurtured our minus elements, who are too
stupid or too vicious to understand anything but
force, to whom the sole criterion of right is
whether you can get away with it. We have cod-
dled them until they have become so powerful that
if we let go of the tail we might as well write finis
to ourselves and our civilization. They are strong
enough to overwhelm the rich and intelligent and
public-spirited. More of them to-day are demand-
ing perpetual care than we are able to control.
Give, give, give. You must give — you who have
the wealth. We must, too — we who wear white
collars and who have suffered during the depres-
sion far more than have many of the pets whom
misguided charity has reared so tenderly.

We have reached a crisis. These border-liners
are having so many unwanted children that they

THE CASE FOR STERILIZATION

are — not from choice — almost doubling their num-
bers every generation. The donors of charity are
becoming gradually fewer, though when they get
free of some of the burden that our degenerates im-
pose on them they will begin to increase.

We know that to-day's need for public relief has
been a terrific strain on ourselves as donors to pri-
vate charity and on our national resources as
well. We know how necessary some of our multi-
initialed Federal enterprises are, how helpful they
have been in relieving the strain on private charity.
But we know, too, that these are but another form
of soothing-syrup, for which our children will
have to pay. Now isn't it obvious — so obvious that
even the morons themselves could see it — that if
the subnormal group, our overgrown pet whose
keeper dares not let go of its tail, continues to grow,
it will not only shake its keeper off but actually
turn and devour him and all his property? The
only mystery is why the keeper himself hasn't long
ago seen this. Is it because he has been only half-
conscious of the growing strength and menace of
the bear, and has refused to admit that the day must
come when he can no longer control it?

I have endeavored to treat the subject of sterili-
zation dispassionately, at the same time presenting

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HOLDING THE BEAR BY THE TAIL

the facts as I know them and as they relate to the
ways in which sterilization may be used as a race-
builder, an eliminator of human misery, and an
agency for increasing the sum total of human hap-
piness.

To recapitulate briefly: we have seen that the
operation itself is a simple one — very simple as
operations go ; and that it does not interfere either
with sexual satisfaction or with the sexual func-
tions except that it insures sterility. We have
noted the great increase in degeneracy in America,
its source, and its cost. We have observed some of
the known inherited human characteristics and the
mode of their inheritance. We have seen that
there are few valid objections and many compel-
ling reasons for making sterilization available to
those who want it, provided they are given com-
plete protection and are made to take time to con-
sider the possible consequences of their decision.
Then we have observed the recognized fact that
many a degenerate does not really want a lot of
children, that he has them as the price he must pay
for pleasure, and that if we will but help him to do
as he really prefers to do, if we will put him on a
par with ourselves in the matters of contraception
and sterilization, he himself will do the very thing
that is best for the future of America — namely,

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THE CASE FOR STERILIZATION

have fewer children. We have seen, too, that a
planned society is practically unthinkable without
sterilization, and that to a certain extent the future
of our race depends on the widest possible applica-
tion of the procedure. But we also know that the
movement has powerful enemies, who for reasons
of their own will probably continue for many years
to oppose all efforts toward race-building. We
therefore propose not only to bring them to their
senses but also — in the name of ordinary justice —
to let them pay for their folly; nay, to insist that
they pay for it.

Twenty years ago the proponents of sterilization
found themselves but voices crying in the wilder-
ness, supported only by a little band of far-sighted
citizens whose common sense told them that like
tends to beget like. Until to-day one has felt in-
adequate, almost solitary, when he tried to urge
his convictions upon the apathetic millions of his
fellow-citizens. If Herr Hitler deserves any ap-
probation at all it must be for his services in
making John Citizen think about sterilization.
Eugenics is being taught now in three-quarters of
our five hundred colleges and universities, and in
many high and preparatory schools. Its teachings
are furnishing texts for thousands of sermons.

HOLDING THE BEAR BY THE TAIL

Though I know of no other like movement that
has had such encouraging growth, there is still
room for a lot of expansion. Not until its mes-
sage has reached every man, woman, and child and
made all of them feel that theirs is the opportunity
to take part in the building of a greater civilization
— not until then will eugenics be living up to its
potentialities. And what can / do, what can you
do, in this cause? Helpless and insignificant we
may be, as individuals ; but by adding each his en-
thusiastic willingness to spread eugenic ideas and
to help educate the opposing forces, we can do a
great deal.

Let me quote from Charles Edward Russell's
article in the October, 1933, issue of Scribner's
Magazine:

Every attack upon every intrenched
evil helps toward the onward motion.
And it makes not the slightest difference
in men's eyes if the attack is fruitless.
There is no such thing in the world as a
wasted protest against any existing evil.
If the protest is made to no more than a
handful of people and is stifled then, it
will, if it is true, just and honest, bear

[289]

THE CASE FOR STERILIZATION

sometime its due measure of fruit. . . .
Nothing pays so well as enlistment in
some betterment movement. It pays —
not in simoleons nor in kudos, but in one's
right to be on good terms with one's self,
which is about all there is in life anyway
which amounts to a hoot. . . . The one
purpose that seems to have either sanity
or actual reward is to keep some step,
however stumbling, however far in the
rear, with the vast, silent, often mysteri-
ous, sometimes hardly discernible proc-
esses that are slowly transforming the
world from a wolves' den to a place
where a man can know some peace, some
content, some joy of living, some sense of
the inexhaustible beauties of the universe
in which he has been placed.

If you can think of any subject or cause that you
could interest yourself in that will yield to you and
to society the same returns that the sterilization
cause will yield, I should like to know what it is.
Every man, every woman, needs some constructive
hobby. Here is a cause to which you can usefully
give as much or as little time as you have to spare.
You will find yourself shoulder to shoulder with

[290]

HOLDING THE BEAR BY THE TAIL

men and women who have the best interests of our
country at heart. None of them is trying to make
any profit, none has any ax to grind. Everybody
has just one objective and is doing his or her part
to achieve it.

We ourselves, admittedly, will hardly live to see
much more than the beginnings of what we are
striving toward. But the world is old, after all ;
the human germ-plasm has been evolving through
countless eons, and there will be human creatures
on earth for many millions of years to come. This
being so, it is little enough for us now to "learn [or
plan] as though we were to live forever, to live as
though we were to die to-morrow." As biology
tells us, though we ourselves shall not live on, the
germ-plasm that created us will go on creating
our children and our children's children. The
Immortal Germ-plasm! When we consider that
in this way we do have immortality of a sort, ought
it not to make us think? Should we not accept
more seriously than we do the responsibility that
is ours? What we do to-day in the direction of
improving the germ-plasm determines what kind
of germ-plasm there will be to-morrow. What are
we going to do about it? Drift? There are those
who see us headed for dire calamity. uAs I watch
America drifting gaily with invincible optimism

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THE CASE FOR STERILIZATION

down the road to destruction, I seem to be con-
templating the greatest tragedy in the history of
mankind," wrote Dr. William McDougall, emi-
nent psychologist — but he wrote it before we had
learned the eloquent fact that the people at the
very top are having enough children to keep their
families perpetuated, before we began to note the
swing toward adequate families in our best-
endowed classes.

America is certainly not bound "down the road
to destruction," notwithstanding some current situ-
ations that must cause us grave concern. Too many
good minds are left, too many persons are eager
and ready to help steer the Ship of State away from
the rocks that loom in the distance. There is fuel
aplenty for that ship, but we have come to see that
navigation is as essential as fuel. We may heartily
rejoice at the promising signs that point unmis-
takably to the fact that a biological revolution is
going on among us, that a new public sentiment is
discoverable which may turn the tide, that there
is developing among us a better type of human
being — idealistic, practical, religious, intelligent,
with sound temperament and noble emotions. Let
us then devote our utmost effort to encouraging this
type, and to discouraging the continuation of those
at the lower end of the social scale.

[292]

APPENDICES

APPENDIX A

THE STUDIES MADE IN CALIFORNIA BY GOSNEY AND

POPENOE

APPENDIX B

TABLES OF INHERITED CHARACTERISTICS

APPENDIX C

NUMBER OF STERILIZATIONS, BY STATES

APPENDIX A

The following technical papers represent the
work of Mr. E. S. Gosney and Dr. Paul Popenoe.
They deal with the workings of the California
eugenical sterilization law and are fundamental
source-material for any one interested in sterili-
zation.

1. THE INSANE. Journal of Social Hygiene, XIII (5) :
257-268, May, 1927.

2. THE FEEBLE-MINDED. Journal of Social Hygiene, XIII
(6); 321-330, June, 1927.

3. SUCCESS ON PAROLE AFTER STERILIZATION. Proc. Amer-
ican Assn. for the Study of the Feeble-minded, 5ist annual
session, 1927, pp. 86-103.

4. CHANGES IN ADMINISTRATION. Journal of Social Hy-
giene, XIII (8) : 466-477, November, 1927.

5. ECONOMIC AND SOCIAL STATUS OF STERILIZED INSANE.
Journal of Social Hygiene, XIV (1)123-32, January,
1928.

6. MARRIAGE RATES OF THE PSYCHOTIC. Journal of Nerv-
ous and Mental Diseases, LXVIII (i) : 17-27, July, 1928.

7. FECUNDITY OF THE INSANE. Journal of Heredity, XIX
(2) : 73-82, February, 1928.

8. MENSTRUATION AND SALPINGECTOMY AMONG THE
FEEBLE-MINDED. The Pedagogical Seminary and Journal
of Genetic Psychology, XXXV: 303-311, 1928.

9. VOLUNTARY STERILIZATION. Proceedings of the 3d Race
Betterment Congress, Battle Creek, Michigan, 1928.

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THE CASE FOR STERILIZATION

10. ATTITUDE OF THE PATIENT'S RELATIVES TOWARD THE
OPERATION. Journal of Social Hygiene, XIV (5) 1271-
280, May, 1928.

11. ATTITUDE OF PATIENTS TOWARDS THE OPERATION.
Journal of Social Hygiene, XIV (5)1280-285, May,
1928.

12. SOCIAL AND ECONOMIC STATUS OF THE STERILIZED
FEEBLE-MINDED. Journal of Applied Psychology, XII
(3): 304-3 1 6, June, 1928.

13. MARRIAGE AFTER EUGENIC STERILIZATION. Proc. of the
$2d annual meeting of the American Assn. for the Study
of the Feeble-minded, 1928.

14. THE NUMBER OF PERSONS NEEDING STERILIZATION.
Journal of Heredity, XIX (9) : 405-411, September, 1928.

15. THE LAW AND HUMAN STERILIZATION. Proceedings of
the 5 1st annual meeting of the American Bar Assn., 1928
(by Otis H. Castle).

1 6. STERILIZATION AND CRIMINALITY. Proceedings of the
$ist annual meeting of the American Bar Association,
1928.

17. EFFECT OF SALPINGECTOMY ON THE SEXUAL LIFE. Eu-
genics, 1(2): 9-23, November, 1928.

1 8. EFFECT OF VASECTOMY ON THE SEXUAL LIFE. Journal
of Abnormal and Social Psychology, 1929.

[296]

APPENDIX 13

TABLE I

INHERITED CHARACTERISTICS IN HUMAN BEINGS
(PARTIAL LIST)

Dominance of One Character and Recessiveness of the Cor-
responding, in the First Generation of Offspring; and Segrega-
tion in the Second and Subsequent Generations.

Body size and shape.

Certain fetal deformities (achondroplasia). Dominant

over normal.
Normal size. Dominant over true dwarfs.

Skeleton.

All the following traits dominate normal condition.
Short digits and limbs (brachydactyly).
Absence of distal phalanges.
Extra digits (polydactyly).
Fused, webbed, or fewer digits (syndactyly).
Fused joints of digits (symphalangy).
Abnormal outgrowths of long bones (exostoses).
Fragility of bones (osteopsathyrosis).
Double-join tedness.

Skin.

Pale thin skin. Dominant over colored thin skin.

Brunet complexion. Dominant over intermediate and
blond.

Spotted white (vitiligo). Dominant over uniformly col-
ored.

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THE CASE FOR STERILIZATION

Excessive formation of blisters (epidermolysis). Domi-
nant over normal.

Hairiness, congenital (hypertrichosis). Dominant over
normal.

Skin thickening, nail marking. Dominant over normal.

Hair.

White forelock. Dominant over normal solid color.
Dark brown. Dominant over light brown to tow and

light reds.

Black. Dominant over all other colors.
Patchy graying of hair (canities). Dominant over normal,

solid color.
Curly, flat cross-section. Dominant over straight, round

cross-section.
Beaded, non-uniform cross-section. Dominant over normal

section.
Digital hair. Dominant over absence.

Eyes.

Brown or black. Dominant over blue.

Hereditary cataract — this and following all dominant over

normal.

Internal pressure and swelling of eyeball (glaucoma).
Displaced lens (ectopia lentis).

Retina pigmentary degeneration (retinitis pigmentosa).
Absence of crystalline lens, congenital (aphakia).
Drooping of eyelid from paralysis, congenital (ptosis).

Ears.

Normal condition. Dominant over deaf-mutism.
Normal condition. Dominant over hardening of ear tissue
(otosclerosis).

Nervous system.

Chronic muscular twitchings ( Huntington's chorea).
Dominant over normal.

[298]

APPENDIX B

Muscular atrophy, progressive neural, both dominant over
normal.

Spontaneous (idiopathic) epilepsy. Recessive to normal.

Constitutional feeble-mindedness. Recessive to normal.

St. Vitus' dance (Sydenham's chorea). Recessive to nor-
mal.

Lack of muscular tone (Thomson's disease). Recessive to
normal.

Kidneys.

Excessive urination (diabetes insipidus). Dominant over

normal.
Excessive sugar in urine (diabetes mellitus). Dominant

over normal.
Urine dark after oxidation (alkaptonuria). Recessive to

normal.

TABLE II

CHARACTERISTICS TENDING TO "RUN IN FAMILIES"

Defective hair and teeth
Extra teeth

Double set of permanent teeth
Harelip and cleft palate

Retention of testes in abdomen (cryptorchidism)
Absence of certain teeth (dental agnesia)
Bilobed ear
Dent in forehead
Human protein sensitization
Double crown of scalp
Stiffening of joints (ankylosis)
Degeneracy of the cornea
Longevity
Handclasp

Constitutional predisposition to certain diseases, such as cancer,
pneumonia, abdominal hernia, inguinal hernia

[299]

THE CASE FOR STERILIZATION

Stuttering or stammering

Anemia in young women (chlorosis)

Nosebleed (epistaxis)

Dilatation of capillaries (telangiectasis)

Splenic anemia

Gout

Goitre

Exophthalmic goitre (Graves' disease)

Ability (a) literary, (b) mathematical, (c) mechanical,

(d) artistic, (e) intellectual
Heart defect
Pernicious anemia
Hardening of arteries (arteriosclerosis)

TABLE III

INHERITED CHARACTERISTICS DOMINANT IN MALES AND
RECESSIVE IN FEMALES

Fissure of parts of eye (coloboma)

Atrophy of optic nerve

Near sight (myopia)

Color blindness (Daltonism)

Night blindness

Rolling of eyes (nystagmus)

Scaly skin (ichthyosis)

Pattern baldness

Degeneration of nerve tissue (multiple sclerosis)

Grower's muscular atrophy (dystrophia muscularis progressiva)

Tendency to abnormal bleeding (hemophilia)

Wanderlust

Deficiency in sense of smell

Sea-lust (thalassophilia)

Toothlessness

Webbed toes

Abnormal smallness of eyes (microphthalmia)

[300]

APPENDIX C

NUMBER OF STERILIZATIONS, BY STATES

The following table shows what many of our
States are doing in regard to sterilization in their
institutions. It shows the number of operations
in each State performed up to January i, 1921;
between then and January i, 1928; between then
and January i, 1932; and between then and Janu-
ary i, 1933. The first column shows the year when
the law was passed or when the latest amendment
was passed to the existing law. A dash means that
in this year there was no law; a cipher means that
there was a law but that no operations were per-
formed. The table does not, of course, show the
many operations performed privately.

[301]

THE CASE FOR STERILIZATION

State

Last

Law

Passed

Alabama 1923

Arizona 1929

California 1917

Connecticut 1919

Delaware 1929

Idaho 1929

Indiana* 1931

Iowa 1929

Kansas ^9*7

Maine 1931

Michigan 1929

Minnesota 1925

Mississippi 1928

Montana 1923

Nebraska 1929

New Hampshire 1929

New York

Nevada

North Carolina .... 1929

North Dakota *927

Oklahoma 1931

Oregon 1925

South Dakota 1927

Utah 1929

Vermont 1931

Virginia 1924

Washington 1921

West Virginia 1929

Wisconsin 1913

Total

Jan. i,

Jan. I,

1921*

1928

0

0

2,558

5,820

27

158

77

o

120

120

49

57

54

647

• '

5

i

1 06

232

0

35

155

308

46

42

42

0

0

0

23

33

•"

o

127

5"

0

0

64

o

27

I

9

0

76

218

3,233 8,515

Jan. I,
1932

76
o

7,548

158

141

o

120

57
657

42

629

508

o

35
386

85

42

o

21

33
o

576

37

79

o

658

9
o

248

Jan. i,
1933

131
20

8,504
338
296

13
217

94

976

4i

1,083
693

12

81
229
165

42
o

46

93
o

882

139

85

30

i,333
20

i
492

12,145 16,056

* The figures given for Indiana do not include the voluntary sterili-
zations of several hundred males between 1899 and 1909, the year
when Indiana passed its first law.

[302]

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